Silent ischemia

Silent ischemia. It occurs when blood flow to the heart muscle is reduced in a partial or complete blockage of the arteries of the heart (coronary arteries). The decrease in blood flow decreases the oxygen supply to the heart .


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  • 1 When this event occurs
  • 2 Causes
  • 3 Risk factors
  • 4 Symptoms
  • 5 Diagnosis
  • 6 Treatment
  • 7 Medications
  • 8 Complications
  • 9 Home Remedies
  • 10 Sources

When this event occurs

Cardiac ischemia occurs when an artery is momentarily narrowed or blocked, preventing oxygen-rich blood from reaching the heart. If the ischemia is severe or lasts too long, it can lead to a heart attack ( myocardial infarction ) and death of heart tissue. In most cases, a momentary interruption of blood flow to the heart causes angina pain . But in some cases there is no pain. This is called silent ischemia.


  • Coronary artery diseaseatherosclerosis ): Atherosclerosis occurs when plaques made of cholesterol and other waste products from cells accumulate on the walls of the arteries and restrict blood flow. Atherosclerosis of the arteries of the heart is called coronary artery disease and is the most common cause of myocardial ischemia. Read more.
  • Blood clotthrombosis ). The plaques that develop in atherosclerosis can rupture, causing a blood clot, which can lead to sudden ischemia, severe myocardial infarction, resulting in a heart attack.
  • Spasm of the coronary artery. A coronary artery spasm is a brief, temporary narrowing (contraction) of the muscles of the arterial wall. This can briefly reduce and decrease or even prevent blood flow to part of the heart muscle. Spasms of the coronary arteries are more common in people with risk factors for heart disease, such as high cholesterol and high blood pressure, but spasms can occur in people who don’t have risk factors, too. Spasms of the coronary arteries can also occur in people suffering from diseases that affect the immune system, such as lupus.
  • Serious illnesses. Myocardial ischemia can occur when the metabolic demands of your increased heart or when the blood pressure is very low due to infection, bleeding, or other serious illness.

Risk factor’s

  • Previous heart attacks.
  • Coronary artery disease.
  • Diabetes mellitus.
  • High blood pressure ( high blood pressure).
  • Coronary arteryabnormalities
  • Smoking.
  • Obesity.
  • Cardiomyopathy.
  • Abuse of alcoholand drugs .


Silent ischemia has no symptoms. But researchers have established that if a person has episodes of chest pain, they may also have episodes of silent ischemia.


To diagnose silent ischemia, the following studies may be done:

  • A stress test can show the flow of blood through the coronary arteries in response to exercise, typically as the patient walks on a treadmill.
  • The Holter study records heart rateand rhythm over a 24-hour period (or longer). The patient is wearing a recording device (the Holter monitor) that is connected to discs that are placed on his chest. Doctors can print and read the recorded data to determine if the patient had episodes of silent ischemia while wearing the Holter monitor.
  • Electrocardiogram(ECG). This test records the electrical activity of the heart through electrodes placed on the skin. Certain abnormalities in the electrical activity of the heart may indicate myocardial ischemia.
  • Blood tests. Certain cardiac enzymes slowly leak into the blood if your heart has been damaged. To help diagnose myocardial ischemia, the doctor may take blood samples for testing for these enzymes.
  • This test uses sound waves to produce an image of the heart. During an echocardiogram, sound waves are directed at your heart from a transducer, a wand-like device, held in your chest. The sound waves bounce off your heart and are reflected through the chest wall and electronically processed to provide video images of your heart. An echocardiogram can help identify if an area of ​​your heart has been damaged and is not pumping normally.
  • Nuclear scintigraphy. This test helps identify problems with blood flow to the heart. Small amounts of radioactive material are injected into the blood stream. Special cameras can detect radioactive material as it flows through the heartand lungs . The areas of reduced blood flow to the heart muscle – through which less of the radioactive material flows – appear as dark spots on the scanner .


Treatment of ischemia is similar to that of any type of cardiovascular disease and generally begins with the following lifestyle changes:

  • Give up smoking.
  • Control high blood pressure, cholesterol and diabetes.
  • Limit alcohol consumption.
  • Adopt healthy eating habits.
  • Begin a doctor-approved exercise program.


  • Aspirin:Your doctor may recommend taking a daily aspirin or other blood thinner. This can reduce the tendency for blood clotting, which can help prevent blockage of the coronary arteries. There are some cases when aspirin is not appropriate, such as if you have a bleeding disorder or if you are already taking another blood thinner, so ask your doctor before you start taking aspirin.
  • Nitroglycerin:This medication temporarily opens the arterial blood vessels, improving blood flow to and from the heart.
  • Beta blockers:These medications help relax the heart muscle, slow the heart rate, and lower blood pressure so that blood can flow to the heart more easily.
  • Cholesterol-lowering medications:By lowering the amount of cholesterol in the blood, especially low-density lipoprotein (LDL), or “bad,” cholesterol , these drugs decrease the main material that is deposited in the coronary arteries. Boosting your high-density lipoprotein (HDL), or “good” cholesterol, may help, too. Your doctor can choose from a wide range of medications, including statins, fibrates, niacin, and bile acid sequestrants.


  • Heart attackmyocardial infarction ). If a coronary artery becomes totally blocked, a lack of blood and oxygen can lead to a heart attack that destroys part of the heart muscle, causing serious and fatal cardiac damage, in some cases.
  • Irregular heart rhythm ( arrhythmia). The heart muscle needs enough oxygen to beat properly. When the heart doesn’t get enough oxygen, the electrical impulses in your heart that coordinate your heartbeat may malfunction, causing the heart to beat too fast, too slow, or irregularly. In some cases, the arrhythmias can be life threatening.
  • Heart failure:The myocardial ischemia can damage the heart muscle, leading to a reduction in its ability to pump blood efficiently to the rest of the body. Over time, this damage can lead to heart failure.

Home remedies

  • Stop smoking. If you smoke, quit. If you need help to quit smoking, talk to your doctor about strategies to quit smoking.
  • Avoid passive smoking. Secondhand smoke can damage the lining of the arteries and increase the risk of developing myocardial ischemia.
  • Manage underlying health conditions. Treat diseases or conditions that can increase your risk of myocardial ischemia, such as diabetes, high blood pressure, and high cholesterol.
  • Eat a healthy diet. Eat a healthy diet with limited amounts of saturated fat, lots of whole grains, and plenty of fruits and vegetables. Know your cholesterol levels and ask your doctor if you have lowered them to the recommended level.
  • Exercise can improve blood flow to the heart. Talk to your doctor about starting an exercise plan.
  • Maintain a healthy weight. If you are overweight, talk to your doctor about weight loss options.
  • Decrease stress. Reduce stress as much as possible. Practice healthy stress management techniques such as muscle relaxation and deep breathing. Read more about how to relieve stress


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