What is the difference between ischemia and infarction?
Ischemia and infarction both refer to conditions in which there is an inappropriate blood supply. However, the degree to which blood flow is restricted in those conditions is different.
Ischemia refers to a situation where the supply of blood and oxygen to a certain part of the body is limited. The cells that are placed in the ischemic area are often still alive. However, they experience stress related to the lack of oxygen.
Infarction, on the other hand, is a further step in ischemia. Sometimes the transition can happen very fast. Infarction is often associated with a complete stop of blood and oxygen supply to a specific region. With time, the cells in the affected body part will undergo necrosis, that is, they will die.
Examples of ischemia and infarction
Ischemia can occur in any part of the body. However, it most commonly affects the heart and brain. In the heart, ischemia leads to angina (pain in the chest). In the brain, ischemia can cause transient ischemic attacks [1, 2].
Infarctions similar to ischemia can happen anywhere, but most commonly they occur in the heart and brain. When an infarction occurs in the heart, it leads to a myocardial infarction, also known as a “heart attack”. In the brain, infarction leads to strokes [3, 4, 5].
Causes of ischemia and infarction
The causes of ischemia and infarction are cardiovascular and are the same for both conditions. The only difference is the degree to which the causes occlude the blood flow.
Ischemia and infarction are most commonly caused by:
- atherosclerosis,
- thrombosis,
- thromboembolism [6, 7, 8].
Risk factors for ischemia and infarction are:
- smoking,
- hypertension,
- diabetes,
- obesity,
- sedentary lifestyle [9, 10].
Symptoms of ischemia and infarction
Ischemia can cause different symptoms. The presentation of ischemia depends on the location where it occurs. Also, the duration of the ischemia-related problems can vary, depending on whether the ischemia resolves or not. Ischemia symptoms can be temporary or, if not treated, permanent.
Ischemia in the brain can lead to:
- problem with vision,
- speech disturbance,
- extremities paralysis,
- walking difficulties,
- confusion,
- drooping of one side of the face,
- vertigo, [11, 12].
When ischemia happens in the heart, it can cause:
- shortness of breath,
- angina,
- pain in the abdomen, arm, jaw, or back,
- heart palpitations,
- fatigue,
- nausea,
- syncope [10].
The symptoms of an infarction depend on its location.
When an infarction is in the heart, it leads to a heart attack. Symptoms of a heart attack include:
- chest pressure (a feeling as if an elephant steps on your chest),
- chest pain,
- radiation of the pain to the arm (especially left), neck back, or jaw,
- nausea,
- shorteness of breath,
- cold sweats,
- heartburn [13, 14].
In cases where an infarction occurs in the brain, it leads to a stroke. Among the symptoms of a stroke are:
- inability to move on your extremities,
- confusion,
- slurred speech,
- numbness,
- difficulty walking,
- memory problems,
- drooping of on side of the face [15].
Diagnosis of ischemia and infarction
The diagnosis of ischemia and infarction involves a combination of examinations. The diagnostic process includes clinical examination, imaging techniques, and laboratory tests.
For ischemia of the brain, visual modalities like MRI and CT angiography can be performed [16].
In cases of heart problems, ECG, CT angiography, MRI, or echocardiography can help in the identification of ischemia or infarction [17].
Additionally, laboratory markers can be used. They indicated biochemical changes in the heart or necrosis. Among the commonly used ones are creatine kinase and troponin [17].
Treatment of ischemia and infraction
The treatment of ischemia and infarction aims to restore blood flow to the deprived region.
Especially in cases of strokes and myocardial infarctions, time is important. The faster the treatment, the better it is for the patient. Early therapy limits the size of the damage in the cut from the blood region.
In strokes, thrombolytic therapy is used to resolve the occultation. It should be performed within the first 3 hours. Stroke patients can receive anticoagulation or antiplatelet therapy [16].
In cases of heart ischemia and infarction, pharmacological and interventional treatment can be used. Patients will receive thrombolytics, and a percutaneous transluminal coronary angioplasty will be performed. However, in some cases, bypass surgery will be needed [17].
Long-term treatment includes a healthy lifestyle combined with anticoagulants to prevent any reoccurrence of ischemia or infarction. Many patients will get, for example, aspirin.