Coronary ischemia

Coronary ischemia, myocardial ischemia, or cardiac ischemia, is a medical term for abnormally <a href="/facts/Ischemia/ySL9xbCl">reduced blood flow</a> in the <a href="/facts/Coronary_circulation/SJhPVTgM">coronary circulation</a> through the <a href="/facts/Coronary_arteries/Xsx1dekd">coronary arteries</a>. Coronary ischemia is linked to <a href="/facts/Heart_disease/HD420nMv">heart disease</a>, and <a href="/facts/Myocardial_infarction/xoGw0qcG">heart attacks</a>. Coronary arteries deliver oxygen-rich blood to the heart muscle. Reduced blood flow to the heart associated with coronary ischemia can result in inadequate oxygen supply to the heart muscle. When oxygen supply to the heart is unable to keep up with oxygen demand from the muscle, the result is the characteristic symptoms of coronary ischemia, the most common of which is chest pain. Chest pain due to coronary ischemia commonly radiates to the arm or neck. Certain individuals such as women, diabetics, and the elderly may present with more varied symptoms. If blood flow through the coronary arteries is stopped completely, cardiac muscle cells may die, known as a myocardial infarction, or heart attack.
<a href="/facts/Coronary_artery_disease/szCt0nVx">Coronary artery disease</a> (CAD) is the most common cause of coronary ischemia. Coronary ischemia and coronary artery disease are contributors to the development of <a href="/facts/Heart_failure/7fckX3Jm">heart failure</a> over time. Diagnosis of coronary ischemia is achieved by an attaining a medical history and physical examination in addition to other tests such as <a href="/facts/Electrocardiography/YpVswJ0W">electrocardiography</a> (ECG), <a href="/facts/Cardiac_stress_test/kL4ovnza">stress testing</a>, and <a href="/facts/Coronary_catheterization/qatJzx1X">coronary angiography</a>. Treatment is aimed toward preventing future adverse events and relieving symptoms. Beneficial lifestyle modifications include smoking cessation, a <a href="/facts/Heart_healthy_diet/QFSlLALT">heart healthy diet</a>, and regular exercise. Medications such as <a href="/facts/Nitrovasodilator/TEv3Nybz">nitrates</a> and <a href="/facts/Beta_blocker/PRsWgpLV">beta-blockers</a> may be useful for reducing the symptoms of coronary ischemia, with beta-blockers also improving long term outcomes in most studies. In refractory cases, invasive procedures such as <a href="/facts/Percutaneous_coronary_intervention/2zlAdul0">percutaneous coronary intervention</a> (PCI) or <a href="/facts/Coronary_artery_bypass_surgery/DDTF1jaB">coronary artery bypass graft</a> (CABG) may be performed to relieve coronary ischemia.
Recently, evidence has been found that ischemia can also occur without coronary obstruction (a conditional known as INOCA - ischemia with no obstructed arteries). Other studies have found that <a href="/facts/Long_COVID/9YQdUEE2">long COVID</a> or post acute COVID syndrome can also be associated with myocardial ischemia. Treatment for both conditions is similar to treatment for ischemia caused by CAD.

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Coronary ischemia