Heart conditions can be ‘silent’
The image many people get when they think
of heart conditions is a grown man cluthing
his chest. But not all heart conditions are
as obvious or pronounced as a heart attack.
Ischemia is a term used to describe the
restriction of oxygen-rich blood to an area of
the body. Cardiac ischemia occurs when the
blood cannot reach the heart.
Generally, cardiac ischemia causes pain
in the chest, known as angina. However, in
some cases, there is no warning pain and the
condition is called silent ischemia.
Facts and fi gures
Silent ischemia affects roughly three to four
million Americans every year. Individuals who
have had a previous heart attack are at higher
risk for silent ischemia than others. But there
are many other risk factors:
• Coronary artery disease
• Coronary artery anomalies
• Alcohol and drug abuse
If ischemia lasts too long or is especially
severe, it may cause a heart attack. It can also
affect the natural rhythm of the heart and its
pumping ability, which can cause fainting, and
even sudden cardiac arrest.
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Silent ischemia has no symptoms. However,
if a person has had previous episodes of chest
pain, there’s a liklihood that he or she could
also be experiencing silent ischemia and not
know it. Doctors may use an exercise stress test
to determine silent ischemia. Also, a special
monitor called a Holter monitor will record the
heart rate and rhythm over the course of a day
and determine if ischemia occurred.
The main way to treat silent ischemia is to
reduce certain behaviors that increase risk. This
includes quitting smoking, avoiding alcohol,
and maintaining a healthy weight and diet.
For those who are diagnosed with silent
ischemia, there are some treatment options
available. Most of these involve improving
blood fl ow to the heart, which often requires
prescription medications. Oxygen also may
be given to increase the oxygen content of the
blood that is reaching the heart. Other people
may take medicines that relax blood vessels,
enabling more blood to fl ow. In most cases, this
is all that is needed to fi x the situation. For those
not responding to treatment, they may need a
percutaneous coronary intervention, such as
balloon angioplasty, coronary artery bypass
surgery, or a similar procedure.
Symptoms and diagnosis
Will I need glasses
after cataract surgery? Millie R. Fell, MD, FACS
By the year 2030, there will be
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Clinical Assistant Professor
of Ophthalmology NYU
1) How strongly do they want to
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If the patient is still working, what kind
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3) Do they drive?
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The new multifocal implants which
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Silent ischemia is a potentially dangerous heart condition that’s
diffi cult to detect and can result in cardiac arrest.