FAQ - Ischemia
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Please tell me about recovery from Acute mesenteric artery ischemia?


My friend had this and it caused some intestine to die, so she had about a foot of it removed. She was only temporarily closed until today, and is still being kept unconscious. Her body is now weeping all over. The dr. says she is doing as well as can be expected. What is a realistic prognosis? She is 72 years old.
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Narrowing of the arteries that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to this area run directly from the aorta, the main artery from the heart.
Mesenteric artery ischemia is often seen in people with hardening of the arteries elsewhere in the body (for example, with coronary artery disease or peripheral vascular disease). The condition is more common in smokers and in patients with high cholesterol.

Mesenteric ischemia may also be caused by a blood clot (embolus) that moves through the blood and suddenly blocks one of the mesenteric arteries. The clots usually come from the heart or the aorta. These clots are more commonly seen in patients with abnormal heart rhythms (arrhythmias), such as atrial fibrillation.

Surgery for chronic mesenteric artery ischemia involves removing the blockage and reconnecting the arteries to the aorta. A bypass around the blockage is another procedure. It is usually done with a plastic tube graft. In the case of chronic mesenteric ischemia, the outlook after a successful surgery is good. However, if appropriate lifestyle changes (such as a healthy diet and exercise) are not made, any problems with hardening of the arteries will generally get worse over time.
Persons with acute mesenteric ischemia usually do poorly, since death of the intestine often occurs before surgery is done. However, when diagnosed and treated right away, patients with acute mesenteric ischemia can be treated successfully. Tissue death from lack of blood flow (infarction) in the intestines is the most serious complication of mesenteric artery ischemia.
Take care always!
MPLF.  (+ info)

My positive thallium test showed ischemia, do I need an angioplasty or just aspoiring and stanins?


Well, depends on if you have symptoms and how are aggressive you are. If it were me and I work in the field, I would definitely have an angiogram done as is recommended with virtually all positive stress tests unless the patient refuses.
The stress testing is more of a screening test.

The angioGRAM is considered the gold standard of diagnosis as stress-testing has inherent false positives and false negatives. It mainly tries to weed out people who may have unknown coronary artery disease. The angiogram is much more expensive and invasive and so when people come in with chest pain. You dont pull out the expensive bigguns of angiogram testing. an angiogram is an xray test of iodine contrast filling the arteries of your heart whereby narrowings can be seen. Stress testing looks at muscle being fed by the arteries and INDIRECTLY infers there might be a problem with the plumbing but cant actually see the plumbing.

The only way to determine if you need medication therapy, a stent or open heart surgery is to determine the size, location and severity of blockages as their could be multiple blockages or just one very mild blockage or a false positive of no significant blockages.
Only the angiogram will tell you the course of treatment necessary. Of course, some people are not interested in that, so one could always opt for medication therapy alone. Although, I sure as hell wouldnt do that and would definitely want to know if I have one foot on a banana peel.

Now you mention angioplasty, that is different that an angiogram although can be performed at the same time following the angiogram. Angiogram is simply the diagnostic portion of the test with catheter squirting iodine in your heart arteries while an xray movie of it is performed. Them they look for narrowings and if appropriate and consent has been given. They can fix it while you are there, so its exploratory. The angioplasty is when you actually fix it by blowing up a ballon that uses a scaffolding to prop the artery open again. Deflate the balloon and that's it in a very basic manner.

Whether you need the "Fix it" angioplasty can only be determined by the angiogram. Some have more severe disease located that would be too risky to try and fix with a simple stent and they are referred for open heart surgery. Most would be prefer the angioplasty. Other times, people have flunked a stress test and they turn to have perfectly clean arteries and they get a clean bill of health.

If you have very small blockages, they may well not intervene and aggressively treat you with statins, ace inhibitors, aspirin and betablockers. The four drugs that prevent heart attacks.

Good luck, but flunking a stress test screening GENERALLY is just the beginning of the process.  (+ info)

Any tips from people with anteroseptal wall ischemia?what is it anyway.?


any medicines or additional tests?thank you very much
I just got my ecg interpretation and it says that I have it. I'm 32 years old.Is there medication or additional tests?Doctors to see?
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Honestly, it would pretty unusual for the average 32 year old.

Start with your primary doctor. She/he may want to start with an echocardiogram or a stress test.

BTW, EKGs are very operator dependent for the reliability.  (+ info)

what is microvascular ischemia? Is there a treatment? What is the relation to high blood pressure?


I just had a MRI that showed a 3' frontal lobe ischemia. Looking for some info while I wait for appt. with nurologist.
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In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia.

Mechanism

Rather than in hypoxia, a more general term denoting a shortage of oxygen (usually a result of lack of oxygen in the air being breathed), ischemia is an absolute or relative shortage of the blood supply to an organ. Relative shortage means the mismatch of blood supply (oxygen delivery) and blood request for adequate oxygenation of tissue.

Ischemia can also be described as an inadequate flow of blood to a part of the body, caused by constriction or blockage of the blood vessels supplying it. Ischemia of heart muscle produces angina pectoris.

This can be due to:

* Tachycardia (abnormally rapid beating of the heart)
* Atherosclerosis (lipid-laden placques obstructing the lumen of arteries)
* Hypotension (low blood pressure, e.g. in septic shock, heart failure)
* Thromboembolism (blood clots)
* Outside compression of a blood vessel, e.g. by a tumor
* Foreign bodies in the circulation (e.g. amniotic fluid in amniotic fluid embolism)
* Sickle cell disease (abnormally shaped hemoglobin)

[edit]

Consequences

Since oxygen is mainly bound to hemoglobin in red blood cells, insufficient blood supply causes tissue to become hypoxic, or, if no oxygen is supplied at all, anoxic. This can cause necrosis and cell death.

Ischemia is a feature of heart diseases, transient ischemic attacks, cerebrovascular accidents, ruptured arteriovenous malformations, and peripheral artery occlusive disease.

Tissues especially sensitive to inadequate blood supply are the heart, the kidneys, and the brain. Ischemia in brain tissue, for example due to stroke or head injury, causes a process called the ischemic cascade to be unleashed, in which proteolytic enzymes, reactive oxygen species, and other harmful chemicals damage and may ultimately kill brain tissue.

Necrosis due to ischemia usually takes about 10-12 hours.

Restoration of blood flow after a period of ischemia can actually be more damaging than the ischemia. Reintroduction of oxygen causes a greater production of damaging free radicals, resulting in reperfusion injury. With reperfusion injury, necrosis can be greatly accelerated.  (+ info)

can an aortic dissection cause unilateral leg ischemia?


does it cause one leg or both legs to be ischemic?
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It CAN cause both or just one. The reason is that the dissection can involve the entire iliac bifurcation, or it can hit just one of the iliacs.  (+ info)

Can you have a partially blocked artery and ischemia and still have a negative electrocardiogram?


Yes and no.

If you are actively experiencing ischemia, then an ECG would almost always show it in some form or another.

The problem is that you often are not experiencing ischemia when the ECG is being taken. You usually are lying back, completely at rest.

Ischemia will really show up when you stress the heart - make it work harder, thereby increasing the oxygenation demands.

There are a variety of stress studies that can be performed to figure all of this out Some involve a treadmill, others are done with chemical stressors if you are unable to walk for instance.

Studies done with a treadmill and imagining are pretty good (around 90% certain) to catch ischemia if its there - but not perfect. If your symptoms still sound concerning and you are the right age, gender, and have the right risk factors, a cardiologist may want to go further and do a much more invasive study of an angiogram.

I hope this is helpful. Good luck.  (+ info)

With ischemia (st-depression) would one's heart sound like a continuous motor rumble in one's body?


I have recently been told I might have this, a stress test confirmed it initially. As I am waiting for more tests, I've noticed that when I lay down my heart sounds like a continuous low rumble noise, and a hertbeat sound on top of that. What would cause this and is this part of the ischemia problem?
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Make sure it is actually your heart and not your lungs, ears, or something else.

Otherwise, talk to your doctor/cardiologist and listen to what he/she has to say. Hearing a murmur without the aid of a stethoscope is not good.

Good luck.  (+ info)

Am diagnosed of anterior septal wall ischemia last dec 11 & ystrday ecg read nonspecific STT wave change?


What is your interpretation of my last ecg reading? Is my schemia worsened after taking medicines 1 blood thinner & 1 for my hypertension? Thank you!
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Nonspecific ST-T wave abnormalities are very common and may be seen in any limb or precordial lead of the electrocardiogram. The changes may be seen in all of the limb and precordial leads (diffuse changes), or they may be present only in the inferior, lateral, or anterior leads.

The types of abnormalities are varied and include straightening of the ST segment, ST segment depression or elevation, flattening of the T wave, or T wave inversion.

Take care as always!  (+ info)

How ischemia can be cured or kept under control?


Assuming you're talking about CARDIAC ischemia....

1) Cure (sort-of) : bypass surgery, stenting

2) treatment : BP control, nitrates, cholesterol meds  (+ info)

I have ischemia (heart) and wonder about heat and massage.?


I have ischemia of the heart (left side I think). I also have a neck vertebrae that injured and hurts periodically. When it's bad I use a heating pad and aspirin which has always helped. I have always preferred a hot bath as well. But, I've had ischemia for 8 years, no treatment until 4 months ago, and I'm just realizing that maybe its not a minor thing.

I wonder now about massage, which I love but don't have often. I was thinking about getting a 2nd opinion on the ischemia because my dr. makes me feel like the ischemia is very minor, and yet I have to take this medicine. My blood pressure was high too and I have an injured knee and neck and torn shoulder so those things are kind of like inflammations - not good for a heart I hear. Thanks for any input.

I am so impressed with this site: the answers and the opportunities for people to learn much more about their important and not so urgent but concerning issues. Thank you all so much.
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It is apparent that you have multiple diseases.,,
1.Ischemic Heart Disease..of the left side
2.Hypertension
3.Post-traumatic injury of Cervical Vertebrae, Knee and Shoulder.
Ischaemic heart disease with hypertension is usually found from middle age onwards. For this combination the treatment has to be continued with out any break.If your doctor says that the ischemia is very minor..it means that you are probably having either an occasional spasm of the coronary vessels(blood vessels that supply blood to heart itself) or there is a sort of stress pattern in your cardiogram. In these cases the treatment is simple but precautions have to be taken. Also you have undergo a thorough cardiological evaluation or checkup. In cases ,just like yours, there is no damage to the heart, while in infarction there is a definite and permanent damage to the heart tissue.
The damaged cervical vertebra can also give rise to pain that may mimic ishemic pain of the heart. That is why I would advise a thorough investigation of your cardiovascular system.
The other orthopedic problem that you have will not affect your cardiac status much, but always tell your doctor about these.
Massaging and local heat is a good combination for getting good relief from such type of pain. And if you are taking the treatment for hypertension regularly, the daily hot water bathing does not matter, but the water must not be too hot.
Please consult a cardiologist and then an orthopedic surgeon... and follow their advice to the hilt.


thanks Zene... for allowing me to be able to help someone.  (+ info)

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