Ischemia, a condition caused by a lack of blood flow, can be life threatening. At Rush, cardiologists, vascular surgeons and interventional radiologists provide expert ischemia treatment in Chicago and the surrounding area. With cutting-edge, minimally invasive treatments, Rush providers can relieve painful ischemia symptoms and reduce your risk of heart attack or stroke.
What Causes Ischemia?
A lack of blood flow to one or more areas of your body causes ischemia. This process occurs when atherosclerosis (a buildup of plaque) or a blood clot blocks or narrows your blood vessels.
There are different types of ischemia, including:
- Myocardial ischemia (also called cardiac ischemia) affects your heart. This can cause chest pain and lead to a heart attack.
- Peripheral ischemia (also called peripheral artery disease) affects your legs. The most severe form can lead to critical limb ischemia. This puts you at risk of losing a limb due to lack of blood flow.
- Mesenteric ischemia affects your digestive system. This type of disease is rare.
- Cerebral ischemia affects the brain. This type of ischemia can cause a stroke.
Several things can increase your risk of developing ischemia, including:
- Family history of heart attack, stroke or peripheral artery disease
- Diabetes
- High blood pressure
- High cholesterol
- History of smoking
- Obesity
- Lifestyle, including excessive stress or inactivity
Signs and Symptoms of Ischemia
The symptoms of ischemia depend on which type you have.
Symptoms of myocardial ischemia include:
- Chest pain (angina)
- Pain in your upper body, including your neck, jaw, shoulder or arm
- Shortness of breath
- Sweating
- Nausea or vomiting
- Arrhythmia (irregular heartbeat)
Symptoms of peripheral ischemia include:
- Severe leg and foot pain while walking that gets better with rest (In more advanced stages, you may also have pain while resting)
- Leg or foot sores that won’t heal
- Shiny, smooth skin on your legs and feet
- Coldness or weakness in your legs
Sometimes, ischemia has no symptoms. This is called silent ischemia. With silent ischemia, you could have a heart attack or stroke without any warning.
If you start experiencing signs of a heart attack or stroke, call 911 or go to the nearest emergency room.
Meet our ischemia providers
How is Ischemia diagnosed?
Rush experts use several diagnostic tests to pinpoint areas where you have ischemia.
Myocardial ischemia tests:
- A nuclear stress test, electrocardiogram (EKG) or coronary angiogram shows where blockages may restrict blood flow in your heart.
- A coronary CT scan can detect narrowing within the heart arteries.
- An echocardiogram evaluates the overall structure and function of your heart.
- A positron emission tomography (PET) myocardial perfusion imaging (MPI) study determines the presence and extent of myocardial ischemia.
Peripheral ischemia tests:
- An ankle brachial index can show blockages in the blood vessels in your legs. This test compares the blood pressure in the ankle and your arm.
Treatment for Ischemia at Rush
If you have blockages in your blood vessels, providers at Rush’s ischemia clinic will work together to develop a personalized treatment plan for you. Our team includes cardiologists, vascular surgeons and interventional radiologists.
You’ll start by discussing your treatment options with your provider. Treatments for ischemia include:
- Lifestyle changes, including exercise, diet and stress management
- Medication to lower your blood pressure or cholesterol
- Interventional radiology and surgical procedures to unblock blood vessels
Interventional and Surgical Procedures
If your provider recommends an interventional radiology or surgical procedure for ischemia, Rush experts are skilled at treating even the most complex cases.
- Angioplasty: This minimally invasive procedure is performed without major incisions. Your provider will insert a small tube, called a catheter, through a tiny puncture in your wrist, arm or groin. They will then thread the catheter through your blood vessels to reach blocked arteries. Usually, your provider will also place a stent to keep your artery open.
- Atherectomy: This procedure is similar to angioplasty. Your provider will insert a catheter with a sharp blade or laser through a small puncture. This tool allows them to remove hard plaque from your arteries, improving blood flow.
- Coronary bypass: If you have severe myocardial ischemia, you may need open heart surgery. This surgery creates a new path for blood to go around a blocked artery in your heart.
- Limb Preservation Services: If you have severe peripheral ischemia, called chronic limb threatening ischemia, you may be told you need an amputation. In many cases, Rush’s limb preservation experts can prevent the need for major amputation. Rush is one of a handful of health systems offering deep venous arterialization, a procedure to create new pathways to replace blocked blood vessels in limbs.
Choosing Rush for Ischemia Care
- A guide at your side: Throughout your care at the ischemia clinic, you’ll work with a nurse navigator. They will help guide you through your treatment, including coordinating between cardiology specialists.
- A team approach to complex cases: Each week, providers from our ischemia clinic meet to discuss patients who have complex needs and symptoms. Together, they’ll share their knowledge and expertise to develop a treatment plan for you.
- Early screening: Our goal is to detect ischemia early, when it’s easier to treat. That’s why our ischemia specialists have ways to identify biomarkers that can indicate your risk for ischemia. They’re doing this by using blood tests and noninvasive imaging that you can self-schedule.
- Minimally invasive options: Rush’s board-certified interventional radiologists and vascular surgeons are experts in minimally invasive ischemia treatments. Many procedures are performed without major incisions, meaning you can recover faster. Our experts perform thousands of minimally invasive procedures each year.
- Innovative care: Our specialists rely on the latest procedures and technology to offer better, safer treatments. For example, Rush is the first facility in Chicago to use the Esprit Below the Knee System. This procedure involves a dissolvable stent that delivers medication directly to blocked arteries, restoring blood flow to the foot and avoiding amputation. Our team also participates in clinical trials that can provide care options that aren't available elsewhere.
- Managing ischemia with rehab: We offer cardiac rehab services to help you prevent or manage ischemia. Our rehab specialists can help you recover from an interventional or surgical procedure as safely and quickly as possible. We can also help you incorporate lifestyle change recommendations into your daily routine.
FAQs About Ischemia Care
Ischemia is caused by a lack of blood flow to one or more areas of your body. This happens when a buildup of plaque or a blood clot blocks your blood vessels. Several factors can raise your risk for ischemia, including diabetes, high blood pressure, high cholesterol, a history of tobacco use, obesity, and family history of heart attack, stroke or peripheral artery disease.
The symptoms of ischemia depend on what area of your body is affected. Symptoms of myocardial ischemia include chest pain, shortness of breath, sweating, nausea and pain in your upper body (neck, jaw, shoulder or arm).
Peripheral ischemia can cause severe leg and foot pain while walking. Other symptoms include leg or foot sores that won’t heal, shiny, smooth skin on your legs and feet and coldness or weakness in your legs.
Sometimes, ischemia has no symptoms.
Interventional radiologists use specialized equipment and imaging to clear blocked blood vessels without large incisions. Atherectomy and angioplasty are two minimally invasive procedures to clear blocked arteries and improve blood flow.
Ischemia and infarction are related conditions. Ischemia occurs when blood flow to a specific area is reduced or restricted but is not completely cut off. With treatment, ischemia can be reversed.
If ischemia is not treated, it can progress to infraction. This occurs when blood flow is completely cut off, causing permanent tissue death. This can cause a heart attack or stroke and is a life-threatening emergency.
Early diagnosis and treatment can prevent ischemia from progressing to infarction.
The recovery process will depend on what type of procedure you have. If you have an interventional radiology procedure, you will likely be able to go home the next day. You will be able to return to most of your normal activities within a week.
If you have open surgery for ischemia, you will likely need to stay in the hospital for several days.
No, you do not need a referral to see a Rush interventional radiologist. Your insurer may require you to get a referral before covering a visit with an interventional radiologist.
Rush’s specialized ischemia clinic offers world-class care in Chicago and the surrounding area. Cardiologists, interventional radiologists and other experts will work together to create a personalized treatment plan for you. Rush offers minimally invasive ischemia treatments that will allow you to recover faster and with less pain than traditional surgery. Our vascular and interventional radiology experts perform thousands of procedures each year.