Ischemia

A lack of blood flow to one or more areas of your body causes ischemia. This process occurs when atherosclerosis (a buildup of plaque) or a blood clot blocks or narrows your blood vessels.

There are different types of ischemia, depending on the area of your body affected:

• Myocardial ischemia (also called cardiac ischemia) affects your heart.
• Peripheral ischemia (also called peripheral artery disease) affects your legs. The most severe form can lead to critical limb ischemia. This puts you at risk for losing a limb due to lack of blood flow. 

RUSH’s dedicated ischemia clinic brings together the following specialists to diagnose and treat ischemia:

• Cardiologists
• Interventional cardiologists
• Heart surgeons
• Vascular surgeons
• Interventional radiologists

Together, they can determine the type of ischemia you have and the right treatment for you.

Causes of Ischemia

The following may increase your risk of developing ischemia:

• Family history of heart attack, stroke or peripheral artery disease
• Diabetes
• High blood pressure
• High cholesterol
• History of smoking
• Obesity
• Lifestyle, including excessive stress or inactivity

Ischemia Symptoms

You may experience various symptoms, depending on the type of ischemia you have.

Myocardial Ischemia Symptoms

Signs of myocardial ischemia are as follows:

• Chest pain (angina)
• Pain in your upper body, including your neck, jaw, shoulder or arm
• Shortness of breath
• Sweating
• Nausea or vomiting
• Arrhythmia (irregular heartbeat)

Peripheral Ischemia Symptoms

Signs of peripheral ischemia are as follows:

• Severe leg and foot pain while walking, but relieved with rest. (In more advanced stages, this can even occur while resting.)
• Leg or foot sores that won’t heal
• Shiny, smooth skin on your legs and feet
• Coldness or weakness in your legs

Silent Ischemia

Some people could have ischemia without any symptoms. This is known as silent ischemia. With silent ischemia, you could have a heart attack or stroke without any warning.

If you start experiencing signs of a heart attack or stroke, call 911 or go to the nearest emergency room.

Diagnosing Ischemia

If you have ischemia in one area of your body, you may also have it elsewhere. At RUSH, we offer the following diagnostic tests to pinpoint the areas where you have ischemia.

Myocardial Ischemia Tests

• A nuclear stress test, electrocardiogram (EKG) or coronary angiogram shows where blockages may restrict blood flow in your heart.
• A coronary CT scan can detect narrowing within the heart arteries.
• An echocardiogram evaluates the overall structure and function of your heart.
• A position emission tomography (PET) myocardial perfusion imaging (MPI) study determines the presence and extent of myocardial ischemia.

Peripheral Ischemia Tests

• An ankle brachial index (ABI) can show blockages in blood vessels in your legs.

Treatment for Ischemia at RUSH

If your diagnostic tests reveal blockages, your provider may refer you to RUSH’s ischemia clinic. In the clinic, cardiologists and vascular surgeons work with you to develop a treatment plan based on your needs.

Our goal with treatment is to relieve your symptoms and prevent other health complications. Left untreated, ischemia may lead to the following health problems:

• Heart failure from myocardial ischemia
• Gangrene or critical limb ischemia from peripheral ischemia

At RUSH, you’ll start by discussing your treatment options with your provider. This could include:

• Lifestyle changes that focus on exercise, diet and stress management.
• Medications to lower your blood pressure or cholesterol.
• An interventional or surgical procedure to improve your condition when lifestyle changes or medications alone do not.

Interventional and Surgical Procedures

Your RUSH provider may recommend a procedure to restore blood flow. RUSH specialists are skilled at treating even the most complex conditions, no matter where your ischemia exists:

• Myocardial ischemia: Interventional cardiologists perform minimally invasive procedures to open your blood vessels and improve blood flow. For severe blockages, heart surgeons can perform open heart surgery to remove or bypass the damaged parts of your artery.
• Peripheral ischemia: Interventional cardiologists and interventional radiologists can perform minimally invasive procedures to open your blood vessels and improve blood flow. Vascular surgeons can remove or bypass the damaged parts of your artery.

RUSH Excellence in Ischemia Care

• A guide at your side: Throughout your care at the ischemia clinic, you’ll work with a nurse navigator. They will help guide you through your treatment, including coordinating between cardiology specialists.
• A team approach to complex cases: Each week, providers from RUSH’s ischemia clinic meet to discuss patients who have complex needs and symptoms. Together, they’ll share their knowledge and expertise to develop a treatment plan for you.
• Early screening: Our goal is to detect ischemia early, when it’s easier to treat. That’s why RUSH ischemia specialists have ways to identify biomarkers that can indicate your risk for developing ischemia. They’re doing this by using blood tests and noninvasive imaging that you can self-schedule.
• Managing ischemia with rehab: RUSH offers cardiac rehab services to help you prevent or manage ischemia. Our rehab specialists can help you recover from an interventional or surgical procedure as safely and quickly as possible. We can also help you incorporate lifestyle change recommendations into your daily routine.
• Limb preservation services: Sometimes peripheral ischemia can get so severe that you could be at risk of losing your limb. At RUSH, our limb preservation team focuses on saving your limb whenever possible. In fact, they offer limb-saving treatments that have helped 90% of their patients keep their limbs.