Ischemia is a condition in which blood flow is restricted or reduced in a particular body part. Whereas silent ischemia refers to ischemia without any feeling of angina in which the heart doesn’t receive enough oxygen or blood, and the patient doesn’t notice any oxygen-deprivation effects in his body. Moreover, in this condition, the patient does not feel any chest pain or unpleasantness as an alarming sign of a heart attack. Ischemic heart disease causes by narrow heart arteries that is also called coronary artery disease or coronary heart disease.
Causes of Silent Ischemia and Ischemic Heart Disease
The main reason behind ischemia diseases is the plaque buildup in the wall of the arteries. The blockage of artery walls hinders the supply of oxygen and blood in the heart. The enlargement of plaque over time obstructs the blood or nutrient flow in arteries.
When the plaque ruptures and tears down the artery wall, a clot forms very rapidly to stop leakage of the blood and completely blocks the blood flow in the heart. Due to a lack of blood, the cell in the heart starts dying.
Difference between Silent Ischemia and Ischemic Heart Disease
Ischemic heart disease and silent ischemia occur due to the contraction of arteries and less blood flow in the heart. Still, the main difference is that patients feel changes in their body during ischemic heart disease like chest pain, angina, fatigue, etc. While in silent ischemia, the patient didn’t notice any pain and faced a sudden heart attack. Silent Ischemia is a senseless or painless disease.
Symptoms of Silent Ischemia and Ischemic Heart Disease
Silent Ischemia doesn’t show any effect on the body and occurs without chest pain/discomfort, so there are no symptoms of this disease for detection.
While the symptoms of Ischemic heart disease are:
- Pain in the jaw or neck
- Pain in shoulder or arm
- A fast heartburn
- Nausea and vomiting
- Sweating
- Palpitation
- Chest pain (angina)
- Fatigue
- Shortness of breath while physically active
Which type of doctor deal with Ischemia?
Expert cardiologists, cardiovascular surgeons, heart surgeons, and cardiothoracic surgeons treat silent ischemia and ischemic heart disease.
Diagnosis of Silent Ischemia and Ischemic Heart Disease
Though silent ischemia is a senseless and painless disease that causes a heart attack without warning signs. Therefore, a diagnostic test is the only way to know about silent Ischemia; the angina sufferers may also have undiagnosed episodes of silent ischemia. People who have diabetes and a record of previous heart attacks also have the chance to fall prey to silent ischemia. It can be detected when the patient is undergoing his stress test for other reasons, like angina or cardiovascular disease. Wearing a Holter monitor continuously is another way to diagnose this problem and treat it accordingly.
Risks Factors of Silent Ischemia and Ischemic Heart Disease
The Risk factors for silent ischemia and ischemic heart disease are listed below:
- Use cigarettes, tobacco, and alcohol
- Diabetes
- High blood pressure or cholesterol
- Any previous heart attack
- Obesity
- A family history of heart disease
- A sedentary lifestyle
- Unmanaged stress
- Aging
Treatment for Silent Ischemia and Ischemic Heart disease
After the appropriate diagnosis of the disease, the doctor will start your treatment procedure based on the specific processes mentioned below:
Maintaining a healthy lifestyle:
- Stop using tobacco, cigarettes, and alcohol of all types
- Prevent or manage diabetes and high blood pressure
- Do regular exercise and try to maintain a healthy weight
- Take a heart-healthy diet such as juices and green vegetables
- Prevent high blood cholesterol
- Visit your doctor daily and have recommended heart screening
Taking medications such as:
- Beta-blockers (reduces heart rate and heart muscle contraction)
- Nitrates (increase the supply of oxygen-rich blood to the heart, reduces heart workload, and relax blood vessels)
- Ranolzine (treats chest pain)
- Calcium channel blockers (helps to relax blood vessel and decrease heart pumping strength)
- Antiplatelet agent (helps in preventing arteries blood clots)
- Angiotensin-converting enzyme (ACE) inhibitors (lowers pressure and keep blood vessels open)
- Diuretics (decrease fluid buildup in heart and lungs, lower blood pressure, and reduce swelling)
- Statins (lowers bad cholesterol)
Oxygen treatment for patients: Oxygen can be used for medical therapy with hypoxemia, carbon monoxide toxicity, and cluster headache to maintain blood oxygen levels.
Surgical Procedures: Patients with all necessary medications and lifestyle changes can further undergo a surgical procedure if the doctor still recommends it. The surgical procedures may include;
Balloon Angioplasty: It is a process used to widen the narrowed or obstructed arteries and veins through a wire with a tiny balloon for treating heart disease.
Coronary Artery Bypass Graft: This surgical process undergoes to restore the blood flow to the affected areas where adequate blood supply is hindered due to the blockage in arteries. In this process, a surgeon uses a vessel from other parts of your body to create a graft that allows blood flow in the heart.
Percutaneous Coronary Intervention: A non-surgical process is used to open the clogged coronary arteries by a catheter, widen the blocked arteries, and keep the blood vessels open.
Enhanced External Counterpulsation: It will be recommended when other treatment options might not work. In this process, outer inflatable cuffs have been wrapped around the legs, gently inflated with air, and then deflated, which helps blood flow to the heart.
Complications of Silent Ischemia and Ischemic Heart Disease
Silent ischemia or ischemic heart disease can lead to further complications in the body:
- Heart attack: If the arteries become continuously blocked, it restricts the oxygen and blood supply in the heart and leads to a heart attack. This damage can be severe or fatal.
- Heart Failure: Repetition of ischemia or ischemic heart disease may lead to heart failure.
- Arrhythmia (irregular heart rhythm): Silent ischemia or ischemic heart disease is the reason behind irregular heart rhythm in the body, which can be life-threatening.
References:
- https://www.mayoclinic.org/diseases-conditions/myocardial-ischemia/symptoms-causes/syc-20375417 retrieved on April 04, 2022.
- https://www.beaumont.org/conditions/silent-ischemia#:~:text=Silent%20ischemia%20occurs%20when%20the,pain%20and%20other%20related%20symptoms retrieved on April 04, 2022.
- https://www.beaumont.org/services/heart-vascular/common-heart-and-cardiac-medications retrieved on April 04, 2022.
- https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/silent-ischemia-and-ischemic-heart-disease retrieved on April 04, 2022.
