Myocardial Ischemia or Ischemic Heart Disease: Causes, Symptoms and Treatment

Myocardial ischemia or ischemic heart disease is an imbalance between the myocardium’s supply and oxygen demand.

Suppose this condition is not treated in time. As a result, it may result in angina pectoris, myocardial hibernation, or in the most severe cases, acute coronary syndrome and myocardial infarction, leading to the death of the affected person.

Myocardial ischemia is the restriction of the blood supply causing the lack of oxygen to the heart caused by the rupture of the artery due to the accumulation of fats and cholesterol (lipids) in the walls of the arteries.

Ischemia is a term used to describe the decrease in arterial blood flow. The reduction of circulation through the heart, known as myocardial or cardiac ischemia, occurs when the arteries that supply the heart contract or become blocked. When the blood flow is compromised, the amount of oxygenated blood reaches the heart muscle, which is equally diminished, forcing the heart to work more than it usually would.


A diagnosis of myocardial ischemia can be confirmed with diagnostic and laboratory tests. Angiography, electro, echocardiograms, and blood tests are often done to assess cardiovascular health and check for markers indicative of heart damage. If atherosclerosis is suspected, the individual may undergo computed tomography (CT) scan to assess the severity of arterial constriction and decreased cardiovascular blood flow.

It is usually diagnosed as a progressive disease; myocardial ischemia can start from an existing cardiovascular dysfunction.


Acute cardiac ischemia may result from sudden arterial obstruction caused by a blood clot or a piece of detached plaque.


Severe systemic infection and hypotension or low blood pressure can also cause a reduction in arterial blood flow, causing ischemic symptoms.

Smoking, obesity, and a sedentary lifestyle dramatically increase the risk of suffering cardiac ischemia. People with chronic diseases with compromised cardiovascular blood flow, such as high blood pressure, also have more ischemic symptoms. People with a family history of heart disease should take precautions to reduce the risk of myocardial ischemia.


Someone with cardiac ischemia may be asymptomatic, meaning that he or she does not experience any sign of something wrong. Those symptomatic may manifest subtle signs, such as nausea and diaphoresis (sweating). Angina pectoris and difficulty breathing with little or no effort can develop as ischemia worsens.

Acute CHF (Congestive Heart Failure), hypotension, and increased pulmonary congestion may also occur.


Myocardial ischemia related to an existing condition may require long-term medication to reduce the risk of progression of symptoms and complications. Aspirin, angiotensin-converting enzyme (ACE) inhibitors, and beta-blockers are often used to reduce the risk of blood clots, relieve arterial constriction, and reduce stress on the heart. If drug therapy is insufficient, surgery may be necessary to unblock or divert the affected artery to restore adequate blood flow.

In patients with severe or acute MI (Myocardial Ischemia) and cardiogenic shock due to ischemic papillary muscle rupture, pharmacological support to the left ventricle, often accompanied by mechanical support, may be necessary.