Heart: Do you know what a silent ischemia is?

Heart: Do you know what a silent ischemia is?

When the normal flow of oxygen-laden blood cannot reach a part of the body at any given time, ischemia occurs. If the blood is directed to the heart and the flow is momentarily interrupted, the event is known as cardiac ischemia. Sometimes it causes pain (angina pectoris). On other occasions it produces no symptoms and is then called silent or silent ischemia. Not being silent is less dangerous. Find out if you are at risk of suffering it and how it is treated.

A symptom is an alert call. Chest pressure, pain, or nausea, for example, indicates that there is a problem with the heart. However, there are conditions, which are presented without prior notice. That is the case of silent ischemia, which receives precisely the name for occurring without raising suspicion.

Ideally, blood can travel freely through the arteries to carry oxygen to all areas of the body. When for different reasons (a high-fat diet, high cholesterol levels, sedentary lifestyle, smoking and / or inheritance, among others), the arteries become clogged or clogged and become increasingly narrow, the blood flow can be interrupted , leaving the heart muscle temporarily devoid of oxygen. This event can cause pain (what we call angina pectoris , the most common symptom of coronary artery disease or CAD  for its acronym in English), or, for reasons that so far are not known exactly, do not produce any symptoms in Some people suffering episodes of ischemia.

It is possible that, despite the fact that the arteries are blocked, the heart can continue to receive enough blood while the person is at rest, but is at risk of suffering from ischemia when performing intense physical activity or is under a lot of stress.

Having no symptoms does not mean it is harmless. If the ischemia is intense and prolonged it can cause a heart attack or, be it a heart attack , which is equivalent to the death of heart tissue. In addition, silent ischemia can have other consequences, such as altering the rhythm of the heart ( tachycardia or ventricular fibrillation), reducing the pumping capacity of the heart, causing fainting or sudden stoppage of the heart (cardiac arrest).

Find out if you are at risk of suffering a silent ischemia

As reported by the American Heart Association (AHA), 3 to 4 million Americans suffer from episodes of silent ischemia. The elderly, those who have suffered a heart attack , those with diabetes and women, are more likely to suffer from it.

The following are the most important risk factors:

  • Having had a previous heart attack
  • Having coronary artery disease (CAD)
  • Have diabetes
  • Having high blood pressure (hypertension)
  • Obesity
  • Excessive consumption of alcohol and drugs
  • Smoking
  • Coronary artery problems
  • Genetics (other people in the family who suffer or have suffered)
  • Lack of physical activity / sedentary lifestyle

How silent ischemia is detected

Silent ischemia gives no symptoms. People find that they almost always in consultation with the doctor, when passing through routine tests, such as an EKG or stress test (known as stress test ) that detects that the heart does not receive enough blood. If people who experience episodes of angina or chest pain are known, they usually also suffer from silent ischemia.

If you have had a heart attack, your cardiologist will pay special attention to detecting it, since silent ischemia increases the chances of having a second heart attack.

How to treat silent ischemia

The treatment for ischemia aims to improve blood flow to the heart and that it receives enough oxygen. The cardiologist will probably prescribe aspirin or another medicine that “thins” the blood; vasodilators of the nitroglycerin type that improve blood flow to the heart; beta blockers to decrease the frequency of heartbeats and lower blood pressure, so that the heart works less. Or I could recommend calcium channel blockers, which also help the heart work less by lowering the pulse and increase blood flow to the heart by acting on the muscle cells of the arteries. Or I could choose to give you one of the angiotensin-converting enzyme or ranolazine inhibitors that use other mechanisms to help the heart work less.

In some severe cases, an intervention is necessary, such as angioplasty and stenting or a coronary bypass or coronary bypass .

Of course, all patients benefit if they make positive changes in their lifestyle. Quitting smoking is essential, as well as avoiding secondhand smoke. A healthy diet and exercise program, approved by the doctor, will provide many benefits. It is also important to control your blood pressure and cholesterol levels, as well as diabetes.

You know what a silent ischemia is about. Do not wait to find out that you have it in the hospital emergency room after having a heart attack. If you have risk factors, consult your doctor and start taking the necessary measures to maintain a healthy heart.

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