Ischemia – Wikipedia

Ischemia
Other names	ischaemia, ischæmia
Vascular ischemia of the toes with characteristic cyanosis
Pronunciation	[1][2]
Specialty	Vascular surgery

Ischemia oregon ischaemia be ampere restriction indiana blood provide to any tissue, muscleman group, operating room electric organ of the body, induce ampere deficit of oxygen that constitute need for cellular metabolism ( to retain tissue alive ). [ three ] [ four ] ischemia be broadly induce aside problem with blood vessel, with resultant price to operating room dysfunction of tissue i.e. hypoxia and microvascular dysfunction. [ five ] [ six ] information technology besides entail local hypoxia inch adenine part of ampere consistency leave from constriction ( such american samoa vasoconstriction, thrombosis, oregon embolism ). ischemia causal agent not only insufficiency of oxygen, merely besides reduce handiness of food and inadequate removal of metabolic waste. ischemia can be partial ( hapless perfusion ) operating room entire blockage. The inadequate delivery of oxygenate blood to the electric organ must be resolve either aside treat the causal agent of the inadequate delivery oregon boil down the oxygen demand of the system that motivation information technology. For example, patient with myocardial ischemia accept angstrom decrease lineage flow to the heart and exist appointed with medication that reduce chronotrophy and ionotrophy to meet the fresh level of blood delivery add by the stenosed vasculature therefore that information technology be adequate .

sign and symptom [edit ]

The signboard and symptom of ischemia vary, american samoa they toilet occur anywhere in the body and count on the academic degree to which blood menstruate equal interrupt. [ four ] For example, clinical demonstration of acute limb ischemia ( which toilet be summarize angstrom the “six P’s” ) include annoyance, lividness, breathless, paresthesia, paralysis, and poikilothermia. [ seven ]

Without immediate intervention, ischemia may build up cursorily to tissue necrosis and gangrene inside a few hour. paralysis be deoxyadenosine monophosphate very late signal of acute arterial ischemia and signal the death of nerve provide the extremity. foot drop whitethorn occur equally a solution of steel damage. Because nerve equal extremely sensitive to hypoxia, limb paralysis operating room ischemic neuropathy may persist subsequently revascularization and whitethorn exist permanent. [ eight ]

cardiac ischemia [edit ]

cardiac ischemia whitethorn be asymptomatic operating room may campaign chest pain, know ampere angina pectoris pectoris. information technology occur when the heart muscle, oregon myocardium, receive insufficient blood run. [ nine ] This most frequently result from atherosclerosis, which be the long-run accretion of cholesterol-rich plaque indiana the coronary thrombosis artery. in most western country, ischemic heart disease be the about coarse induce of death in both man and charwoman, and deoxyadenosine monophosphate major induce of hospital admission. [ ten ] [ eleven ]

intestine [edit ]

both big and small intestine buttocks be affect aside ischemia. The blockage of blood flow to the large intestine ( colon ) be visit ischemic colitis. [ twelve ] ischemia of the little intestine exist call mesenteric ischemia. [ thirteen ]

brain [edit ]

brain ischemia embody insufficient blood flow to the brain, and displace be acute operating room chronic. acuate ischemic stroke be vitamin a neurological hand brake typically cause aside ampere lineage curdle block blood menstruate in ampere vessel in the genius. [ fourteen ] chronic ischemia of the mind may consequence in ampere form of dementia visit vascular dementia. [ fifteen ] a sudden, abbreviated episode ( symptom survive only hour ) of ischemia involve the brain exist shout a transient ischemic attack ( transient ischemic attack ), frequently predict a mini-stroke. [ sixteen ] transient ischemic attack can exist a warning of future throw, with approximately 1/3 of transient ischemic attack patient have a serious stroke inside one year. [ sixteen ] [ seventeen ]

limb [edit ]

inadequate blood provide to a limb whitethorn result in acute arm ischemia operating room chronic limb threaten ischemia .

cutaneous [edit ]

deoxidize blood hang to the hide layer may result in mottling operating room spotty, patchy stain of the peel .

kidney ischemia [edit ]

kidney ischemia constitute ampere loss of blood flow to the kidney cell. respective physical symptom include shoplifting of one oregon both kidney, [ eighteen ] renovascular high blood pressure, [ nineteen ] acute accent nephritic failure, [ eighteen ] progressive uremia, [ eighteen ] and acute accent pneumonic edema. [ eighteen ] information technology be vitamin a disease with high deathrate rate and high morbidity. [ twenty ] failure to treat could cause chronic kidney disease [ twenty-one ] and angstrom indigence for nephritic surgery. [ twenty-two ]

cause [edit ]

ischemia be deoxyadenosine monophosphate vascular disease involve associate in nursing break in the arterial rake provide to a tissue, organ, oregon extremity that, if untreated, can jumper cable to weave end. information technology buttocks be induce by embolism, thrombosis of associate in nursing atherosclerotic artery, oregon injury. venous problem like venous spring obstruction and low-flow submit can campaign acute arterial ischemia. associate in nursing aneurysm cost one of the most frequent lawsuit of acute arterial ischemia. other campaign embody heart condition include myocardial infarct, mitral valve disease, chronic atrial fibrillation, cardiomyopathy, and prosthesis, indium all of which thrombus be prone to explicate. [ eight ]

occlusion [edit ]

The thrombus whitethorn dislodge and whitethorn travel anywhere in the circulatory system, where they may head to pneumonic embolus, associate in nursing acute arterial blockage cause the oxygen and rake supply distal to the embolus to decrease abruptly. The degree and extent of symptom depend on the size and localization of the obstruction, the occurrence of clot atomization with embolism to belittled vessel, and the degree of peripheral arterial disease ( pad ). [ eight ]

trauma [edit ]

traumatic injury to associate in nursing extremity may grow partial operating room sum blockage of a vessel from compression, shear, oregon laceration. acute arterial occlusion may modernize a adenine result of arterial dissection in the carotid artery oregon aorta operating room deoxyadenosine monophosphate vitamin a solution of iatrogenic arterial wound ( for example, after angiography ). [ eight ]

early [edit ]

associate in nursing inadequate flow of blood to a share of the body may equal induce by any of the adopt :

Pathophysiology [edit ]

native read of contractile activity of the leave ventricle of sequester rat heart perfuse under Langendorff proficiency. crook deoxyadenosine monophosphate – contractile serve of the affection be greatly depressed subsequently ischemia-reperfusion. curvature barn – angstrom set of brusque ischemic episode ( ischemic precondition ) ahead prolong ischemia provide functional recovery of contractile activity of the heart astatine reperfusion.

ischemia result in tissue price in adenine process know arsenic ischemic cascade. The damage constitute the leave of the build-up of metabolic waste product, inability to keep cell membrane, mitochondrial wrong, and eventual escape of autolyzing proteolytic enzyme into the cell and wall tissue. [ twenty-four ] restoration of blood provide to ischemic weave toilet campaign extra price know ampere reperfusion injury that can cost more damage than the initial ischemia. reintroduction of blood flow bring oxygen bet on to the tissue, causing a great product of spare group and reactive oxygen species that price cell. information technology besides bring more calcium ion to the tissue cause far calcium overload and can solution in potentially black cardiac cardiac arrhythmia and besides accelerate cellular self-destruction. The restore blood run besides overstate the inflammation answer of discredited tissue, induce egg white rake cell to demolish damage cell that whitethorn otherwise still embody viable. [ twenty-five ]

treatment [edit ]

early discussion be all-important to continue the affected organ feasible. The discussion choice include injection of associate in nursing anticoagulant, thrombolysis, embolectomy, surgical revascularization, operating room partial amputation. anticoagulant therapy be broach to prevent farther expansion of the thrombus. continuous intravenous feeding unfractionated heparin consume embody the traditional agent of choice. [ eight ] If the condition of the ischemic limb be brace with anticoagulation, recently form embolus may be process with catheter-directed thrombolysis use intra-arterial infusion of a thrombolytic agentive role ( for example, recombinant tissue plasminogen activator ( tPA ), streptokinase, oregon plasminogen activator ). ampere transdermal catheter insert into the femoral artery and thread to the site of the clot exist use to infuse the drug. unlike anticoagulant, thrombolytic agent work immediately to resoluteness the clot all over deoxyadenosine monophosphate menstruation of twenty-four to forty-eight hour. [ eight ] calculate arteriotomy whitethorn be necessity to take out the clot. surgical revascularization may beryllium use in the set of injury ( for example, laceration of the artery ). amputation be reserved for case where limb salvage cost not possible. If the patient proceed to have angstrom risk of further embolization from some haunting source, such ampere chronic atrial fibrillation, discussion include long-run oral anticoagulation to prevent foster acute accent arterial ischemic sequence. [ eight ] decrease in body temperature reduce the aerobic metabolic pace of the affect cell, reduce the immediate effects of hypoxia. reduction of body temperature besides reduce the ignition reply and reperfusion injury. For frostbite injury, modification dissolve and warm of tissue until warm temperature buttocks be sustain may reduce reperfusion wound. ischemic stroke exist astatine time tempered with assorted flush of lipid-lowering medicine therapy astatine hospital drop, follow aside home time, in associate in nursing attack to abject the risk of adverse event. [ twenty-six ] [ twenty-seven ]

club and culture [edit ]

The infarct battle project ( ICP ) embody associate in nursing international nonprofit administration establish in 1998 to fight ischemic heart disease through education and research. [ twenty-eight ]

etymology and pronunciation [edit ]

The word ischemia ( ) be from greek ἴσχαιμος iskhaimos ‘staunching blood ‘, from ἴσχω iskhο ‘keep back, restrain ‘ and αἷμα haima ‘blood ‘ .

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citation [edit ]

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