Ischemia

Ischemia is a condition in which the blood flow (and thus oxygen) is restricted to a part of the body. Cardiac ischemia is the name for lack of blood flow and oxygen to the heart muscle.

Ischemic heart disease

It's the term given to heart problems caused by narrowed heart arteries. When arteries are narrowed, less blood and oxygen reaches the heart muscle. This is also called coronary artery disease and coronary heart disease. This can ultimately lead to heart attack.

Ischemia often causes chest pain or discomfort known as angina pectoris.

Silent ischemia

As many as 3 to 4 million Americans may have ischemic episodes without knowing it. These people have ischemia without pain - silent ischemia. They may have a heart attack with no prior warning. People with angina also may have undiagnosed episodes of silent ischemia. In addition, people who have had previous heart attacks or those with diabetes are especially at risk for developing silent ischemia.

Having an exercise stress test or wearing a Holter monitor - a battery-operated portable tape recording that measures and records your electrocardiogram continuously, usually for 24-48 hours - are two tests often used to diagnose this problem. Other tests also may be used.

Heart Attack Symptoms and Warning Signs

If you think you're having a heart attack, call 9-1-1 or your emergency medical system immediately.

Some heart attacks are sudden and intense - the «movie heart attack», where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath. May occur with or without chest discomfort.
• Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness.

How do I know if a heart attack has occurred?

A doctor who's studied the results of several tests must diagnose a heart attack. The doctor will

• review the patient's complete medical history.
• give a physical examination.
• use an electrocardiogram (ECG or EKG) to discover any abnormalities caused by damage to the heart. An ECG is a medical device that makes a graphical record of the heart's electrical activity.
• sometimes use a blood test to detect abnormal levels of certain enzymes in the bloodstream.

Blood tests confirm (or refute) suspicions raised in the early stages of evaluation that may occur in an emergency room, intensive care unit or urgent care setting. These tests are sometimes called heart damage markers or cardiac enzymes.