What is Ischemia?
The ischemia definition is simply a “deficient supply of blood to a body part (…the heart or brain) that is due to obstruction of the inflow of arterial blood”.1 Myocardial ischemia is a situation in which the blood flow meant for the heart is reduced, and the heart does not receive enough oxygen. Most likely the reduction in blood flow results from blockage to the arteries of the heart. Sometimes this condition is called cardiac ischemia, and it can lead to heart muscle damage and the heart not pumping efficiently. If there is “a sudden, severe blockage of a coronary artery”, that “can lead to a heart attack”. The medical condition, myocardial ischemia, could cause abnormal rhythms of the heart, as well. Causes of this disorder include atherosclerosis (coronary artery disease), blood clot, or coronary artery spasm. The chest pain may be triggered by emotional stress, cold temperatures, physical exertion, or cocaine use. Myocardial ischemia can develop slowly or all at once. Risk factors for developing this condition include tobacco use, diabetes, high blood pressure, high blood cholesterol and triglycerides, obesity, physical inactivity, and having “a waist measurement of more than 35 inches (89 centimeters) for women and 40 inches (102 cm) in men”.2 Mesenteric ischemia refers to damage to the small intestine. Risk factors for this condition include renal failure, blood clots, a prior myocardial infarction, heart failure, or atrial fibrillation. In fact, “chronic disease is a risk factor for acute disease”.3 Cerebral ischemia affects the brain, and it is considered a “sub-type of stroke”. The brain’s metabolism becomes altered due to the lack of oxygen. There are two types of this condition: focal (a specific region) and global (covers wide areas). Risk factors for this brain disorder include sickle cell anemia, ventricular tachycardia, blood vessels that are compressed, plaque building up in the arteries, low blood pressure, congenital heart defects, and heart attack.4
Symptoms of Ischemia
Some patients may have “silent ischemia”, with no symptoms, while others with cardiac ischemia would have chest pain on the left of the body and some other symptoms (especially in older people, diabetics, and women). These other symptoms include jaw or neck pain, arm or shoulder pain, fast heartbeat, shortness of breath during activity, vomiting or nausea, fatigue, and sweating. Complications of myocardial ischemia include heart attack, arrhythmia (irregular rhythm of the heart), and heart failure.5 Symptoms of mesenteric ischemia include unintentional weight loss, vomiting, being afraid to eat, and abdominal pain after a meal.6 Symptoms of cerebral ischemia include double vision, dizziness, vertigo, weakness in a leg or arm, blindness in an eye, slurred speech, trouble speaking, or loss of coordination. The signs can last from seconds to “extended periods of time” and “may become permanent”. Some patients could become unconscious or experience brain damage or death.7
Medical Treatments and Prevention
For the ischemia that affects the brain, one medication is Alteplase. Patients may be prescribed heparin or warfarin as anticoagulants. It is possible that surgery, such as carotid stenting or carotid endarterectomy will be necessary if there is excessive plaque.8 Treatment for the disorder that impacts the intestines will include “NG tube decompression, angiogram for diagnosis and treatment, heparin anticoagulation”, as well as “papaverine to decrease arterial vasospasm”. Surgery may also be required, including procedures such as “surgical revascularization” or “bowel resection”.9 Medical treatment for the heart disorder involves using medications or surgery to improve the blood flow. It is also important to engage in healthy lifestyle choices to prevent such conditions.10 Healthy choices include quitting smoking, eating a healthy diet (fruits, vegetable, whole grains), exercise, maintaining a healthy weight, stress reduction (deep breathing, muscle relaxation), and managing underlying medical conditions. Patients should work on treating or preventing high blood pressure, elevated cholesterol, or diabetes.11 Regular chiropractic care can be a part of maintaining a healthy lifestyle and in treating conditions that put the body under stress. It is useful for pain management. In addition, the chiropractor can provide dietary counseling and may have massage therapists on staff. Massage therapy can help to release natural endorphins, reducing pain without medication, and it is an effective tool for stress and circulatory problems, as well.12 Lifestyle changes can prevent many types of disease. Eating foods that are low in sodium, trans fat, and saturated fat, while eating plenty of fiber, seeds, and nuts could be beneficial. If a patient eats animal products, it may be helpful to substitute fish, poultry, and low fat dairy, while limiting red meat. Physical activity is important, such as engaging in “at least 2½ hours (150 minutes) of moderate-intensity aerobic physical activity…or 1 hour and 15 minutes (75 minutes) of vigorous intensity aerobic physical activity…every week”. These exercises could include walking, jogging, or running. In addition, muscle-strengthening is also important and should be engaged in “2 or more days a week”.13