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Differences Between Myocardial Ischemia and Myocardial Infarction
Myocardial ischemia and myocardial infarction are both conditions defining the failing condition of the heart muscle. While myocardial ischemia is characterized by a decrease in blood supply to the heart tissue which leads to chest pain or angina pectoris, myocardial infarction is the end point of this ischemia that results in death of heart tissue due to absence of blood supply. Myocardial infarction is what is commonly termed as a heart attack and is often the result of a prolonged and untreated myocardial ischemia.
Difference between causes
The causes of myocardial infarction are same as that of myocardial ischemia as untreated myocardial ischemia leads to infarction. The causes are as follows:
- Coronary artery disease (CAD) is the commonest cause of myocardial ischemia because it is produced due to a reduced blood supply and these arteries are responsible for regulating the blood supply to the heart. In this condition, the arteries become narrow and lose their elasticity due to collection of cholesterol plaques inside the arterial wall, thereby reducing the blood flow to the heart muscle itself. This cholesterol aggregation is termed as atherosclerosis.
- Blood clots obstructing the blood flow through heart’s arteries can also lead to myocardial ischemia.
- Coronary artery spasm is a condition where the muscles within the walls of the arteries supplying the heart tighten thereby reducing the blood supply to heart.
- In addition to the above causes, there are plenty of other risk factors which have a major impact in the development of myocardial ischemia like smoking, chewing tobacco, diabetes mellitus, hypertension, increased cholesterol levels, obesity, lack of physical exercise and a strong family history.
Difference between signs and symptoms
All the signs and symptoms of myocardial ischemia are seen in case of myocardial infarction. Along with these symptoms, it can present with few other symptoms. In case of ischemia, patient suffers from a feeling of chest heaviness, pain or pressure especially on the centre of the chest, or left side and the pain can be felt even in neck, jaw, shoulder or left arm. and In rare cases, it is also seen on the right side, with a sensation of nausea, vomiting and breathlessness on slightest exertion.
In case of ischemia, the patient may present with excessive sweating, fatigue, palpitations, sensation of heartburn and light headedness along with all the above symptoms. Sometimes it may so happen that the patient may not complain of any of these symptoms and suffer a ‘silent heart attack’ which is seen in case of patients suffering from diabetes mellitus since a long time. If the ischemia is too sudden and severe, leading to instant infarction and death soon after, within a matter of minutes.
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Ischemia and Infarction
Ischemia means the absence of blood flow to the organ or body tissues, while Infarction implies the death of tissues due to reduced blood supply. Reduced blood supply leads to the shortage of oxygen supply to the affected organ or body tissue.
A CT scan helps to evaluate
- the stroke (Ischemic stroke- due to insufficient blood flow)
- the hemorrhage- rupture of the blood vessel or
- any other problem.
Sometimes, CT scans cannot diagnose a stroke because of
- Poor imaging as compared to MRI,
- The stroke region being too small to be detected.
The Brain does not become abnormal for a few hours after the onset of stroke. Thus, MRI is helpful for clear imaging of the damaged region.
Treatment for myocardial ischemia is mainly to increase the blood flow to the heart. Following medicines help to relieve symptoms.
- Aspirin: By oral route of administration.
- Nitro-glycerine: The route of administration can be under the tongue or intravenously.
- Nitrates: The route of administration can be under the tongue or intravenous infusions.
In anterolateral ischemia, the ST segment of ECG is elevated. This gives the possibility that the patient is at high-risk blocks, i.e., ischemia.
The change in lifestyle can prevent Inferolateral Ischemia.
- Quit smoking
- Decrease stress
- Manage health condition likes diabetes, high blood pressure, high cholesterol, etc.
- Maintain a healthy weight, i.e., no overweight
- Eat a healthy diet.
Some people who have myocardial ischemia don’t have any signs or symptoms (silent ischemia).
When they do occur, the most common is chest pressure or pain, typically on the left side of the body (angina pectoris). Other signs and symptoms — which might be experienced more commonly by women, older people and people with diabetes — include:
- Neck or jaw pain
- Shoulder or arm pain
- A fast heartbeat
- Shortness of breath when you are physically active
- Nausea and vomiting
Factors that can increase your risk of developing myocardial ischemia include:
- Tobacco. Smoking and long-term exposure to secondhand smoke can damage the inside walls of arteries. The damage can allow deposits of cholesterol and other substances to collect and slow blood flow in the coronary arteries. Smoking causes the coronary arteries to spasm and may also increase the risk of blood clots.
- Diabetes. Type 1 and type 2 diabetes are linked to an increased risk of myocardial ischemia, heart attack and other heart problems.
- High blood pressure. Over time, high blood pressure can accelerate atherosclerosis, resulting in damage to the coronary arteries.
- High blood cholesterol level. Cholesterol is a major part of the deposits that can narrow your coronary arteries. A high level of “bad” (low-density lipoprotein, or LDL) cholesterol in your blood may be due to an inherited condition or a diet high in saturated fats and cholesterol.
- High blood triglyceride level. Triglycerides, another type of blood fat, also may contribute to atherosclerosis.
- Obesity. Obesity is associated with diabetes, high blood pressure and high blood cholesterol levels.
- Waist circumference. A waist measurement of more than 35 inches (89 centimeters) for women and 40 inches (102 cm) in men increases the risk of high blood pressure, diabetes, and heart disease.
- Lack of physical activity. Not getting enough exercise contributes to obesity and is linked to higher cholesterol and triglyceride levels. People who get regular aerobic exercise have better heart health, which is associated with a lower risk of myocardial ischemia and heart attack. Exercise also reduces blood pressure.
Myocardial ischemia can lead to serious complications, including:
- Heart attack. If a coronary artery becomes completely blocked, the lack of blood and oxygen can lead to a heart attack that destroys part of the heart muscle. The damage can be serious and sometimes fatal.
- Irregular heart rhythm (arrhythmia). An abnormal heart rhythm can weaken your heart and may be life-threatening.
- Heart failure. Over time, repeated episodes of ischemia may lead to heart failure.
The same lifestyle habits that can help treat myocardial ischemia can also help prevent it from developing in the first place. Leading a heart-healthy lifestyle can help keep your arteries strong, elastic and smooth, and allow for maximum blood flow.