Myocardial Ischemia


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.


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:

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.

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.

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Last reviewed by a Cleveland Clinic medical professional on 05/18/2018.

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