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Angina & Ischemia
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Angina & Ischemia

What is the difference between angina and ischemia? Last time I ended up in the ER with angina that felt like a heart attack, it was diagnosed as Ischemia.????

Thanks, Ally
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367994_tn?1304957193
Ischemia is a blockage of the vessels, and the blockage prevents sufficient blood flow to an area of the heart causing chest pain (angina).  To experience angina without treatment can cause permanent damage to heart cells.

Opening the occluded vessel/vessels with a stent or medication should relieve the chest pain.
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144586_tn?1284669764
Well, not exactly.

Ischemia simply means the tissue is not getting enough oxygen. Depending upon how long the tissue is oxygen deficient permanent damage may result. The time to damage is called "warm ischemic time". It varies with the organ. Ischemia can be due to suffocation, which does not involve blocking any blood vessels at all, or carbon monoxide poisoning.

Ischemia of the heart in an ER is operationally defined as a depressed ST segment on the EKG.

Angina refers to pain due to the heart not getting enough oxygen due to a problem with the main blood supply to the heart. Rather than a blockage, the problem is often a spasm of the muscles surrounding the blood vessel, much like a "charlie horse", generally when the interior diameter has already been narrowed by deposits.

Nitroglycerine is a vasodilator, which relieves the spasm, and enables the blood vessel to open up and provide more oxygenated blood to the heart.

The word "heart attack" is a lay term and pretty meaningless.
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367994_tn?1304957193
Wikipedida: "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".  That is totally consistent with what I posted.  Your elaboration is appreciated.

You are referring to the mechanisms for hypoxemia and that could also include anemia, etc.!!!!  Outside the scope of the question.
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237039_tn?1264261657
I have recently experienced some "angina" that wakes me up and rest does not relieve this, but nitro does.  I will go back to sleep and it will happen again maybe an hour or so later.  I woke up yesterday feeling some pressure in chest and bouts with angina off and on during the day.  But last night I slept great and without any pain.  I am starting to worry again, that I will get used to this and not seek help when I should.  The reason I don't rush off to the ER anymore is because I go, they run a few tests and then send me home with meds.  ??? I am not sure anymore when to go and when not to.  The doctor just seems to  note that I am experiencing chest pains and writes new scripts for the same meds. ???

Thanks for the replies.  Good to hear from you again KenKeith.

Ally.
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367994_tn?1304957193
Ally, you have the classic signs if unstable angina. When one experiences angina that indicates the heart cells are not receiving sufficient blood/oxygen.  If not successfully and timely treated, heart cells can irreversibly damaged.  The fact you find relief with nitro substantiates the chest pain is associated with blood flow to the heart tissues.

You should get a blood test, chest X-ray, and at least an EKG in ER.  You should see a cardiologist for a stress test.  Take care.
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