Myocardial Ischemia (Cont.)

 
Unstable Myocardial Ischemia
Unstable myocardial ischemia is a dangerous condition that requires emergency treatment. It is a sign that a heart attack could occur soon. Unlike stable myocardial ischemia, it does not follow a pattern. It can occur without physical exertion and is not relieved by rest or medicine.
 
Variant Myocardial Ischemia
Variant myocardial ischemia is rare; it usually occurs at rest. The pain associated with this can be severe, and usually occurs between midnight and early morning. This pain can usually be relieved by medicine.
 

Causes of Myocardial Ischemia

Myocardial ischemia is caused by a temporary lack of oxygen-rich blood to the heart muscle. This decrease in blood flow can happen for a number of reasons and will vary based on the type of myocardial ischemia. In most cases, the cause of myocardial ischemia is coronary artery disease (CAD), or what most people refer to as just heart disease. Sometimes, other types of heart disease (such as aortic stenosis) or uncontrolled high blood pressure (hypertension) can cause myocardial ischemia.
 

Triggers of Myocardial Ischemia

For a lot of people (especially those with stable myocardial ischemia), symptoms of myocardial ischemia are triggered by:
 
  • Physical exertion, such as exercise, hurrying, or sexual activity
  • Emotion (stress, anger, frustration, or fright)
  • Exposure to very hot or cold temperatures
  • Heavy meals
  • Smoking.
     
Unstable and variant myocardial ischemia are usually not associated with triggers.
 

Risk Factors for Myocardial Ischemia

Specific myocardial ischemia risk factors include:
 
  • Coronary artery disease, also known as coronary heart disease
  • Other heart diseases, such as aortic stenosis or hypertrophic cardiomyopathy
  • Previous heart attack
  • Age.
     
Stable and unstable myocardial ischemia occur more often in older adults. People with variant myocardial ischemia are often younger than those with other forms of the condition.
 
(Myocardial Ischemia Continued: Page 3)

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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD