What Is Ischemia?

Written by Nicole Schmidt
Medically Reviewed by Poonam Sachdev on July 24, 2025
10 min read

Ischemia is a condition in which some parts of your body don’t get enough blood. That means they’re also not getting enough oxygen. It can happen in your brain, heart, and legs, among other areas.

You usually get ischemia because of a buildup or blockage in your arteries. What it feels like and how it affects you depends on where you get it. But it can lead to life-threatening problems such as a heart attack or stroke.

One of the main causes of ischemia is atherosclerosis, which happens when plaque collects in your arteries. Plaque is a hard, sticky substance that’s made mostly of fat. It builds up slowly, so you might not even know it’s there at first. But over time, it can harden and narrow your arteries, leaving less space for your blood to move through.

“It’s like a kink in a hose,” says Simona Campa-Cochrane, a cardiology nurse practitioner at UT Southwestern Medical Center. “Water can still flow though it but not enough.” 

You can also get ischemia because of a blood clot. Plaque is harmful on its own, but if a plaque buildup breaks open, it can form a clot. This can suddenly block blood flow in that area, which can be life-threatening. Sometimes, a piece of a clot can break off and travel to another part of the body. This can cause problems there, too.

Other possible causes of ischemia include:

  • A strangulated abdominal hernia, a condition in which part of your intestine gets trapped in a hernia and can’t get enough blood
  • Very low blood pressure 
  • Vasculitis, an autoimmune disease that causes swelling in your blood vessels and makes it harder for blood to flow through them

You can also get ischemia when a health care provider puts medical equipment into your arteries.

What’s the difference between infarction and ischemia?

With ischemia, your body isn’t getting enough blood, which means your cells and tissues don’t get enough oxygen. Both ischemia and infarction affect the arteries, but an infarction is more serious. It happens when blood flow stops completely and tissue starts to die. This can cause a heart attack if it affects your heart or serious damage to other organs, such as the lungs. Doctors need to monitor ischemia closely, but an infarction needs emergency medical treatment.

Certain lifestyle habits raise your chances of getting ischemia. These include: 

  • Using tobacco products
  • Not getting enough exercise
  • Taking certain medications, including birth control pills

You might also have a higher chance of ischemia if you have health conditions such as:

  • A previous stroke or heart attack 
  • Chronic kidney disease
  • Diabetes
  • Ischemia in another part of your body
  • High or low blood pressure
  • High cholesterol levels
  • Obesity
  • Sleep apnea
  • Blood clotting disorders

Your genes also play a role, especially in ischemic stroke and heart disease. If a close family member had one of these conditions, you’re more likely to have it, too.

Take time to understand your risk factors, says Campa-Cochrane, who holds a doctoral degree in nursing practice. “Our genes are a powerful driver of heart disease, and understanding your genetic makeup can help you make better decisions for yourself,” she says. “It’s like knowing what’s in your bank account.”

Doctors divide ischemia into types according to what part of your body it affects. Some types may be mild and won’t cause any issues at first. Others can be life-threatening. 

Myocardial ischemia

Myocardial ischemia may also be referred to as ischemic heart disease or cardiac ischemia. This type of ischemia affects the heart muscle. It usually happens when fat and cholesterol (plaque) builds up in your coronary arteries, which limits how much oxygen and nutrients your heart gets. Over time, this can damage your heart muscle and lead to serious problems, such as an irregular heartbeat, a heart attack, heart failure, or even sudden cardiac death if your heart stops and you don’t get treatment right away.

Peripheral or limb ischemia

This type of ischemia affects how much blood flows to one or both of your hands, legs, or feet. It happens when plaque builds up in the arteries of your arms or legs — a serious condition known as peripheral artery disease (PAD).When too little blood gets through, this can damage your tissues and may even cause them to die. This can lead to a serious condition called gangrene, which often affects the toes and feet.

If it’s not treated in time, you could lose your hand, foot, arm, or leg.

Mesenteric ischemia

Mesenteric ischemia is uncommon. It lowers blood flow to parts of your digestive system (including the large and small intestines). When a blockage stops blood from reaching these organs, the tissue can start to die. Your intestines contain trillions of bacteria that help you digest food. But if your intestines are harmed, those bacteria can spread elsewhere in your body, causing a life-threatening infection like sepsis.

Mesenteric ischemia can be chronic (develops slowly over time as the arteries narrow) or acute (sudden). Acute mesenteric ischemia is a medical emergency.

Transient ischemic attack (TIA)

A transient ischemic attack (TIA) is a temporary stroke, often called a “mini stroke.” A brief lack of blood flow to your brain causes it. Even though the symptoms usually only last a few minutes, a TIA can damage brain cells and needs immediate treatment.

A TIA can also be a warning sign of a future stroke. This could happen within a few minutes or hours or after a few days.

Ischemic stroke

This type of ischemia also affects the brain. But unlike a TIA, the stroke doesn’t stop on its own. It happens when a blockage stops blood from reaching the brain, which can cause permanent brain damage. A stroke needs to be treated at once to avoid long-term harm.

Not everyone notices ischemia symptoms. Some people have silent ischemia in the heart or brain. This is when you have ischemia but don’t notice pain or any other signs or symptoms. It can lead to a heart attack or stroke that seems to come out of the blue.

If you do get symptoms, they vary based on where you have ischemia. If you think you might have it, get medical help right away. Here are symptoms you might have with different types of ischemia.

Myocardial ischemia symptoms

The most common symptom of myocardial ischemia is chest pain (doctors call it “angina”). If you have this type of ischemia, you could also:

Peripheral or limb ischemia symptoms

When plaque builds up in the arteries of your arms or legs (called PAD), you may notice:

  • Coldness and weakness in your legs
  • Pain in your feet
  • Serious pain in your legs, even when resting
  • Shiny, smooth skin on your legs and feet
  • Sores that won’t heal

Mesenteric ischemia symptoms

With mesenteric ischemia, you might have symptoms such as:

Transient ischemic attack (TIA) symptoms

The symptoms of a TIA are similar to that of a regular stroke and may include: 

  • Weakness on one side of your body or the inability to move on one side
  • Trouble speaking
  • One side of your face droops 
  • A sudden loss of one or more of your senses
  • Blurred vision 
  • Dizziness

Ischemic stroke symptoms

The symptoms of an ischemic stroke include:

  • Personality changes or mood swings
  • Having trouble speaking (or not being able to speak at all)
  • Headaches
  • Feeling irritated or confused
  • Feeling dizzy or nauseous
  • Memory loss (amnesia)
  • Loss of coordination
  • Being unable to see clearly (having blurry or double vision)
  • Paralysis or weakness on one side of your face
  • Passing out
  • Seizures
  • Suddenly losing one or more of your senses, including sight, smell, taste, hearing, and touch
  • Throwing up

Call 911 if you have symptoms of any kind of stroke.

To diagnose ischemia, your doctor will start by asking you about your symptoms and health history. Then, they’ll do a physical exam to check where the problems are. Based on what they find, they may order more tests to make a diagnosis.

The type of test you’ll need depends on which part of your body is affected. These might include:

  • Blood tests
  • Exercise stress test, which measures how well your heart is working during physical activity
  • Ankle-brachial index (ABI), which compares blood pressure in your arms and ankles to detect poor circulation
  • Imaging tests, such as an X-ray, ultrasound, CT scan, MRI, or PET scans
  • Echocardiogram, a type of ultrasound that checks how well your heart is working
  • EKG, a quick, noninvasive test to measure your heart’s electrical activity
  • Colonoscopy or sigmoidoscopy, which allow a doctor to examine the inside of your intestines
  • Angiography, which uses dye to track how blood flows through your arteries
  • Electroencephalogram, a test that uses small, metal discs secured to your scalp to measure brain activity

The kind of ischemia treatment you’ll get depends on what type you have and how serious it is. In mild cases, lifestyle changes to help lower your cholesterol and improve your overall health can make a big difference. 

The best thing someone can do to help manage or keep ischemia from happening is to quit smoking, she says. “This also includes vaping,” Campa-Cochrane says. “We don’t really have enough data to understand how it damages the inside of the arteries.”

Other lifestyle changes might include:

  • Exercising for at least 30 minutes, five times a week
  • Maintaining a healthy weight
  • Eating more nutritious foods, such as fruits and vegetables
  • Avoiding or limiting alcohol

Your doctor may recommend drugs to help manage your ischemia and make sure it doesn’t get worse, including: 

  • Blood pressure medication 
  • Cholesterol-lowering medication 
  • Blood thinners (called anticoagulants) 
  • Antiplatelets, which stop your blood cells from sticking together 
  • Thrombolytics, to break up existing blood clots 
  • Antibiotics

For cases of ischemia that are further along, you may need surgery. The type of procedure will depend on the area affected but may include: 

  • Angioplasty and stenting, surgery to open up more space inside an artery 
  • Thrombectomy to remove a blood clot from an artery or vein
  • Peripheral artery bypass surgery, which creates a new path around a blocked artery in your leg
  • Atherectomy, which uses a catheter with a sharp blade or laser to get rid of plaque from inside your arteries
  • Coronary artery bypass surgery to restore normal blood flow to your heart
  • Endarterectomy to remove plaque from blocked or narrowed arteries

You can help lower your chances of ischemia by making healthy lifestyle choices. These include:

It’s also helpful to see your doctor for regular checkups. They can check for issues such as high blood pressure, high cholesterol, and diabetes. This might help you catch problems early, before you even have symptoms.

It’s never too soon to start making lifestyle changes, Campa-Cochrane says.

“​​The choices we make in our 20s and 30s affect our health in our 40s, 50s, and into retirement,” she says.

Ischemia happens when something, often plaque buildup or a blood clot, blocks or limits blood flow to a part of your body. It can damage your heart, brain, intestines, or limbs. In serious cases, it may cause permanent damage or even death. You can lower your chances of getting ischemia by quitting smoking, staying active, and managing high blood pressure or cholesterol. Also, keep other conditions, such as diabetes, under control.

If you notice any symptoms or are concerned about your risk, talk to your doctor. They can help you make a plan to help avoid or treat the problem.

Here are some commonly asked questions about ischemia.

Does ischemia always mean a blockage​?

Not always. Even though ischemia can be caused by a blockage, it can also happen if your arteries are too narrow for enough blood to flow through them.

What should you avoid when you have ischemia?

If you have ischemia, avoid smoking and using other tobacco products, including vaping, since they can make your condition worse. Stay away from foods that are high in cholesterol, saturated and trans fats, and salt. Avoid missing doses of any medications you’re prescribed.

What is microvascular ischemia?

Microvascular ischemic disease affects small blood vessels in your brain. It’s more common in older adults and can cause a range of problems, such as trouble focusing or even a stroke.

What is inferior wall ischemia?

Inferior wall ischemia affects the inferior wall of your heart. That means there’s less blood flowing to the lower part of your heart. It can cause chest pain. If it’s not treated, it can lead to a heart attack.