Ischemia: Causes, Symptoms and Complications, Risk Factors, Treatment and Prevention

It can be defined as an insufficient supply of blood to a tissue or organ caused by a contracted or obstructed blood vessel.

When this limitation does not allow the passage of a blood flow for a long time, it can trigger damage in the affected area and may even cause death.

Causes

Ischemia is caused by two leading causes, when there are blocked blood vessels or when those vessels are narrowed or constricted.

But specific causes depend on which organ is affected; therefore, the conditions that can cause ischemia are:

1. In the heart:

• Coronary artery disease (atherosclerosis)

Atherosclerosis is the most common cause of myocardial ischemia. The plaques that accumulate in the walls of the arteries, composed mainly of cholesterol, fat, and calcium, restrict blood flow, causing blockages in the streets.

• Blood clot

The plaques that produce atherosclerosis can break down, forming a blood clot.

This clot can block an artery and lead to sudden and severe myocardial ischemia, which causes a heart attack.

• Spasm of the coronary artery

A coronary artery spasm is a sudden and temporary coronary artery contraction and is an unusual cause of myocardial ischemia.

Ischemia can cause a heart attack, heart failure, and irregular heartbeat. It can cause severe pain in the chest, called “angina pectoris” or sudden cardiac death.

This type of condition, when it occurs at the level of the heart, is called ischemic heart disease, myocardial ischemia, or cardiac ischemia.

1. In the brain:

Brain ischemia is a condition that occurs when there is not enough blood flow to the brain; this leads to a limited supply of oxygen or cerebral hypoxia and can cause a cerebral infarction, brain tissue death, or ischemic stroke.

There are two types of ischemia:

• Focal ischemia: occurs in a specific region of the brain.
• Global ischemia: occurs in large areas of brain tissue. This is the cause of a stroke.

1. In the extremities:

Called “critical ischemia of the extremities.”

This occurs mainly in the legs and is caused by a blockage of the main arteries responsible for carrying blood to the legs.

It can occur more frequently in people suffering from high blood pressure, diabetes, or atherosclerosis.

This is a serious condition since it is a complication of peripheral arterial disease (PAD).

1. In the intestines:

Intestinal ischemia is a blockage in an artery of both the small and large intestine, caused by the formation of a blood clot or narrowing of a street; these blockages can occur in the veins but are rare.

Symptoms and complications

The symptoms vary according to the place where the ischemia occurs, and these are:

1. Heart

symptom

•  Pain in the chest or angina.
• Tachycardia.
• Pain in the neck, jaw, shoulder, or arm.
• Sweating
• Stomach upset or vomiting
• Fatigue.

Damage

•  Myocardial infarction.

1. Brain

symptom

• Severe and sudden headache, sometimes dizziness or vomiting, and double vision.
• Fainting.
• Mobility problems, weakness, numbness in the face, arm, or leg on one side of the body.
• Difficulty speaking.

Damage

• Irreversible damage to the area where the ischemia occurred.
• Death of brain tissue.
• Cerebral infarction or ischemic stroke can cause disability and death.

1. Legs

symptom

• Coldness and weakness in the legs.
• Feet ache.
• Severe pain in the legs, even when lying down.
• The bright and soft skin on the legs and feet.
• Ulcers.

Damage

• Edemas.
• Critical ischemia results in lost limbs.

1. Intestines

symptom

• Abdominal pain.
• Swelling in the abdomen
• Blood in the stool.
• Diarrhea.
• Vomiting or upset stomach

Damage

• Death of intestinal tissue.
• Intestinal perforation.
• Scarring or narrowing of your colon.
• Death.

Risk factor’s

Several factors increase the risk of developing ischemia, which includes:

• Heart diseases.
• Diabetes.
• High blood pressure.
• High levels of cholesterol and triglycerides.
• Age.
• Obesity.
• Sedentary life.
• Stress.
• Tobacco consumption.
• Underlying vascular diseases.
• Venous thrombosis

Treatment

Early detection and rapid evaluation of symptoms are necessary. The treatment aims to restore blood flow and avoid damage to the affected areas and organs.

Surgery may be required to remove dead tissue or repair areas with injuries. Once the treatment is completed to repair this event, it aims to prevent future ischemia.

Common treatments to reduce ischemia and restore blood flow include:

• Administration of thrombolytic drugs to dissolve clots, medicines to dilate blood vessels, prevent the future formation of clots, reduce the heart’s workload, and control pain.
• Oxygen therapy
• Procedures to expand blood vessels, stenting.
• Surgery or procedures to remove lumps and repair blocked blood vessels.

Diagnosis

The diagnosis will depend on the organ where the ischemia occurs. For the diagnosis of ischemia, the diagnostic tests include the following:

Heart

• Physical and laboratory examination.
• Electrocardiogram (ECG).
• Echocardiography
• Angiography.

Brain

• Physical and laboratory examination.
• Computed tomography.

Extremities

• Physical and laboratory examination.
• Pulse exam.
• Doppler evaluation.
• Duplex ultrasound.
• Computed tomography angiography (CTA).
• Magnetic resonance angiography (MRA).

Bowels

• Physical and laboratory examination.
• Abdominal x-ray.
• Ultrasound
• Exploratory laparotomy.

Prevention

It can help reduce the chances of suffering from ischemia.

These practices include:

• Ingestion of more fruits, vegetables, and whole grains and less fat
• Exercises
• Stress reduction: yoga breathing exercises or meditation
• No Smoking
• Control diseases like diabetes, high blood pressure, and high cholesterol.