Ischemia is a condition in which the blood flow to the tissue decreases and the tissue's oxygen demand cannot be met. It can be seen in every tissue in the body. Ischemia, especially seen in the heart and brain, can cause serious health problems that can threaten life.
What is Ischemia?
Tissues need oxygen and nutrients in order to survive. The structures that deliver these substances to the tissues are the blood vessels. Occlusion in any large or small blood vessel in the body causes ischemia. In case of ischemia, damage occurs in the tissue fed by the occluded vessel.
One of the most common causes of ischemia is hardening of the arteries, namely atherosclerosis. In atherosclerosis; A hard and sticky plaque, mostly composed of fat, begins to form in the vessel. Plaque formation is a time-consuming process. Therefore, the person may not notice this situation at first. The plaque gradually hardens, reducing the diameter of the vessel, causing the vessel to narrow. As a result, the blood flow in the narrowed vessel is also reduced.
Another cause of ischemia is blood clots. While the plaque formed in the vein is a problem in itself, it can also burst and form a clot. This can cause sudden cessation of blood flow in the vein. In some cases, the blood clot breaks into smaller pieces and may travel to other parts of the body and cause ischemia in that area.
Ischemia can cause very serious damage to tissues. The most common problems caused by ischemia can be listed as follows:
Heart: Ischemia occurring in the heart; Also known as myocardial ischemia or cardiac ischemia. This can cause heart diseases such as heart attack, arrhythmia (irregular heartbeat), heart failure. Ischemia can also lead to chest pain called 'angina' and sudden cardiac death.
Brain: Cerebral ischemia or cerebral ischemia can cause a stroke. This condition, which is caused by the formation of plaque in the leg arteries (arteries), can lead to severe pain that does not go away even at rest. If ischemia in the leg is not treated, serious conditions can occur that can cause the patient to lose his leg.
Intestines: Mesenteric ischemia affects both the small intestine and the large ligament It is a disease that can affect the stomach. In mesenteric ischemia, the part of the intestine that cannot be fed properly due to reduced blood flow may die or perforate (perforate).
What are the Symptoms of Ischemia?
Symptoms of ischemia may differ according to the tissue in which ischemia is seen. Sometimes, patients may not have any symptoms related to ischemia. This situation, which is defined as silent ischemia, is especially seen in ischemias of the heart or brain. When patients with silent ischemia experience a heart attack or stroke, this seems like an unexpected event. However, there is a long-standing ischemic process in the patient's organs. Ischemia in different organs causes different symptoms. Not all symptoms caused by ischemia can be seen in every patient.
Symptoms of myocardial ischemia:
- Chest pain (angina)
- Faster than normal pulse (tachycardia)
- Neck, jaw, arm and pain radiating to the shoulder
- Shortness of breath
- Excessive sweating
- Nausea, vomiting
- Fatigue, exhaustion.
- Severe and sudden onset headache, sometimes accompanied by dizziness and vomiting
- Faintness
- Difficulty moving the body (numbness, weakness, or inability to move the face, arm, or leg on one side of the body)
- Inability to speak clearly and clearly and understand what other people are saying
- Coldness, weakness in the legs
- Feeling of pain in the foot
- Pain in the legs that continues even at rest
- Bright and smooth appearance of the skin of the legs and feet
- It can be considered as a non-healing wound on the leg.
- Severe abdominal pain
- Bloating
- Bloody stool (stool)
- Diarrhea
- Feeling of not being able to fully defecate
- Nausea, vomiting
How is Ischemia Treated?
The main goal in the treatment of acute ischemia is to increase the blood flow to the tissue by expanding the narrowed vessel. Myocardial ischemia treatment is aimed at improving the blood supply of the heart muscle. . For this, both drug treatments and surgical methods can be used.
The drugs that can be preferred for the treatment of myocardial ischemia:
- Aspirin
- Nitrates
- Beta blockers
- Calcium channel blockers
- Cholesterol lowering agents
- Angiotensin converting enzyme (ACE) inhibitors
- Ranolazine.
Angioplasty: In this procedure, a thin tube-shaped instrument is generally advanced from the femoral artery (the artery in the groin) towards the heart. When the narrowed vessel in the heart is reached, the balloon-like structure in the device is inflated. A stent can be placed in the related area so that the corrected vessel does not narrow again.
Bypass Surgery: In this surgery, the vessels causing ischemia are replaced with vessels taken from another part of the body. Since the bypass is performed as an open surgery, it is usually applied to patients who have problems in more than one vessel and cannot be treated with angioplasty. Cerebral ischemia can cause a serious picture in the brain called ischemic stroke. Ischemic stroke should be treated urgently in the early period so that it does not cause major damage to the brain. The aim of ischemic stroke treatment is to restore normal blood flow to the brain. Treatment methods that can be applied for this:
Intravenous (IV) Drug Administration: In order to apply this treatment, the patient must have applied to a well-equipped health center a few hours after the first symptom appears. In this method, the patient is given a drug called tissue plasminogen activator (tPA) intravenously. tPA helps dissolve the blood clot that causes ischemia in the brain and improves blood flow to the brain. In this way, it is possible to save the patient without serious damage to the brain. The earlier tPA is given to the patient, the less likely it is to damage the patient's brain.
Endovascular Procedures: In these procedures, the treatment is applied directly to the vessel where the obstruction is. As in angioplasty in the heart, a stent can be inserted into the vein, or the clot is removed by administering various drugs to the vein.
Removal of obstruction in leg vein i In China, angioplastic methods, bypass surgery or clot-dissolving drugs can be used. The doctor considers parameters such as the location of the occluded vessel, the severity of the occlusion, and the general condition of the patient to determine which treatment will be applied.
Sudden mesenteric ischemia needs to be treated urgently. In acute mesenteric ischemia, blood flow to the intestine suddenly stops. This leads to the death of the involved intestinal tissue. Sometimes this tissue can be punctured and the intestinal contents can be dispersed into the abdominal cavity. The intestinal contents are not sterile and contain a large number of bacteria. As a result of the distribution of this content into the abdominal cavity, infection may develop in the abdomen. In order to prevent perforation of the intestine, the part of the dead intestine that does not bleed properly can be surgically removed.
In chronic mesenteric ischemia, balloon opening of the clogged vessel and placing a stent can be performed to improve the blood circulation of the intestine. Ischemia is a condition that causes very serious health problems. Early detection of ischemia is of great importance in order to minimize ischemia-related damage to tissues and organs. People showing signs of ischemia should apply to the nearest health center without wasting any time. In acute ischemia, the patient can be successfully treated with immediate restoration of the blood circulation that has stopped. Since silent ischemia does not cause any symptoms, a general health check should be done regularly for early diagnosis of this condition. You can use the contact form on our website to reach us.
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