What is myocardial ischemia?
Myocardial ischemia means your heart muscle is not getting enough blood (which contains oxygen and nutrients) to work as it should.
Symptoms and Causes
What are symptoms of myocardial ischemia?
The most common symptom of myocardial ischemia is angina (also called angina pectoris). Angina is chest pain that is also described as chest discomfort, heaviness, tightness, pressure, aching, burning, numbness, fullness, or squeezing. It can feel like indigestion or heartburn.
There are 2 types of angina: stable angina/stable coronary artery disease and unstable angina. Stable angina usually stops soon after you rest or take medication to control it. Unstable angina can happen at any time, even when you are relaxed or sleeping. It may not go away when you take medication.
Symptoms of myocardial ischemia can also include:
- Pain or discomfort in the upper body, including the arms, left shoulder, back, neck, jaw or stomach
- Trouble breathing or feeling short of breath
- Sweating or "cold sweat"
- Feeling full, indigestion, or a choking feeling (may feel like heartburn)
- Nausea or vomiting
- Feeling light-headed, dizzy, very weak or anxious
- Fast or irregular heartbeat
If you have angina or any of the symptoms of ischemia listed above that last for more than 5 minutes, CALL 9-1-1 RIGHT AWAY! You may be having a heart attack or have a coronary artery that is completely blocked.
It is possible to have ischemia ─ or even a heart attack ─ and not have any warning signs. This is called silent ischemia. This is most common in people with diabetes, but it can happen to anyone with heart disease.
What causes myocardial ischemia?
Ischemia is most likely to happen when your heart needs more oxygen and nutrients than it is getting. It is simply a supply-demand imbalance that happens at times when there is more demand for blood, such as when you are active, eating, excited, stressed or in the cold, and your body can’t keep up with the need for more blood.
The supply problem can be caused by coronary artery disease. This is a build-up of plaque and cholesterol inside the coronary arteries. The build-up narrows the artery so much that the oxygen-rich blood the heart needs can’t get through, and the heart muscle becomes starved for oxygen. This causes ischemia and angina. (need picture of obstructive CAD).
Another cause of myocardial ischemia is coronary spasm. This happens when the coronary arteries spasm, which temporarily reduces or cuts off blood supply to the heart.
Management and Treatment
What treatments are available for patients with myocardial ischemia?
Your treatment for myocardial ischemia depends on the cause of the problem. Your doctor will talk to you about the treatment that is best for you, which may include medications or procedures to improve blood flow to the heart muscle.
- Learn more about coronary artery disease risk factors, diagnosis and treatment options.
- Learn more about diagnosis and treatment of coronary spasm
Doctors Who Treat
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.
Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons
Choosing a doctor to treat your coronary artery disease depends on where you are in your diagnosis and treatment.
Click on the following links to learn more about Sections and Departments treat patients with Coronary Artery Disease:
- Cardiovascular Medicine
- Cardiothoracic Surgery Department
The Miller Family Heart, Vascular & Thoracic Institute offers specialty centers and clinics for patients whose treatment requires the expertise of a group of doctors and surgeons who focus on a specific condition.
- Advanced Ischemic Heart Disease Center
- Preventive Cardiology Programs and Clinics
- Women’s Cardiovascular Center
See: About Us to learn more about the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute.
If you need more information,click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
Becoming a Patient
Diagnostic tests are used to diagnose coronary artery disease and the most effective treatment method.
Our webchats and video chats give patients and visitors another opportunity to ask questions and interact with our physicians.
- Coronary Artery Disease Webchats and Video Chats
- All Miller Family Heart, Vascular & Thoracic Institute webchats
- Coronary Artery Disease and Treatments Videos
- All Miller Family Heart, Vascular & Thoracic Institute Videos
Additional information and resources
- Recovery at Home
- Support Groups and Information
- Visit Health Essentials - Read articles on coronary artery disease and healthy living on Health Essentials
- Follow Heart, Vascular & Thoracic Institute webchats and news stories on Twitter*
- Subscribe to Heart, Vascular & Thoracic eNews
- American Heart Association*
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The inclusion of links to other websites does not imply any endorsement of the material on those websites nor any association with their operators.
Why choose Cleveland Clinic for your care?
Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don't hesitate to ask.