Ischemia

By Alex Bigale PTA

Overview of Ischemia 

Ischemia by definition is a deficit in blood supply (oxygen) to tissues in the body. This could include any part of the body, but most commonly happens with disorders that affect the brain, heart, and lower legs. Bodily tissues require a blood supply to bring nutrients to survive and function. When blood supply is cut off (ischemia) these tissues begin to die or become necrotic.

Causes of Ischemia

There are two common causes of ischemia. One of which is atherosclerosis and the other is a blood clot.

• Atherosclerosis: A build-up of fatty plaque in the arteries that occurs over time. Once there is enough plaque in an artery it can begin to occlude the blood flow and cause ischemia further down the line to the tissues.
• Blood Clot: A build-up of plaque that breaks off the side of the blood vessel and then gets stuck in a smaller portion of the artery-blocking the flow.

Terminology for ischemia affecting different areas:

• Brain: This is called a stroke and can be life-threatening/altering depending on the time the brain is without oxygen.
• Heart: Names can vary from angina (chest pain) to heart attack or heart failure depending on how much the arteries that supply the heart muscle with oxygen are occluded.
• Legs: Peripheral Artery Disease (PAD) is the leading cause of Critical Limb Ischemia that can result in amputation if not treated.

Symptoms

There are not always symptoms with ischemia, but when symptoms are present, they will vary depending on the area of the body that it occurs in.

• Brain:
  • A headache that is intense and occurs quickly (dizziness or vomiting can occur with this).
  • Fainting.
  • Slurred Speech.
  • Weakness or numbness of the face, arm, or legs.
• Heart:
  • Chest pain.
  • Faster than normal heart pace.
  • Pain in the Jaw, Neck, or shoulder/arm.
  • Shortness of breath.
  • Increased sweating.
  • Nausea.
• Legs:
  • Cold and weak legs.
  • Pain in your feet or calves.
  • Pain even while resting.
  • Shiny/smooth skin on your legs and feet.
  • Cuts or sores that do not heal.

Ischemia After Surgery:

Following any type of surgery, especially one that involves a lower extremity, it is possible to develop an ischemic condition. Deep Vein Thrombosis (DVT) is a blood clot that develops in the deep veins of the thigh or calf. This typically occurs after a surgery that causes a patient to become sedentary for a prolonged period of time.

• Symptoms of DVT include pain, swelling, red or discolored skin, or distended veins. Other than these symptoms, DVT can become life-threatening if the blood clot breaks loose and travels to the lungs (pulmonary embolism). These symptoms include shortness of breath, chest pain, coughing, or spitting up blood. If you have these symptoms, you should immediately seek medical attention.
• Treatment of DVT most likely begins with anticoagulants or blood thinners to help dissolve the clot and prevent it from blocking pathways. If this is ineffective then surgical intervention may be necessary.
• Prevention of DVT usually starts with devices such as compression stockings or pneumatic compression devices that help blood flow and prevent pooling of blood. Another method of preventing DVT (ischemia) is to begin moving early on with ambulation and exercises such as ankle pumps. Typically, physical therapy is ordered to begin treatment for a joint replacement and educate the patient on these specific interventions.

JOI and JOI Rehab

JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.

To make appointments with JOI Rehab, please call 904-858-7045.

By: Alex Bigale PTA