Question

Why is “silent ischemia” more common in patients with diabetes?

If a patient’s fecal stool examination is positive for occult blood, what does this indicated?

Answer 1

Ischemia :

It is a condition with reduced blood flow and reduced oxygen supply in any part of the body. Decreased blood flow to cardiac muscle is called cardiac ischemia. Also called ischemic heart disease or coronary heart disease. Ischemia is reversible. Prolonged loss of supply to heart causes death or cardiac tissue resulting in infarction which is irreversible.

Silent ischemia :

The first major symptom of ischemia is chest pain or discomfort knows as angina pectoris

When ischemia occurs without chest pain or other symtoms, it is called silent ischemia. Heart attack may occur without prior warning like chest pain, sweating, palpiations and dyspnea.

Silent ischemia occurs in :

=>Diabetic patients

=>Hypertensive patients

=>Patients with previous episodes of myocardial infarction

=>Advanced age

=>Surgical revascularization

Reason for silent ischemia in diabetes :

The chest pain felt during ischemia is due to the stimulus of pain going above the pain threshold in the peripheral nerves. In diabetes, a complication called diabetic neuropathy results in autonomic denervation due to which pain stimulus is not felt.

Occult blood in stool:

Occutl blood in stool is abnormal blood detected in the stoor indicating abnormal bleeding in the digestive tract. It is most commonly caused by lower digestive tract bleeding.

Causes for occult blood in stool:

=>Colonic cancer(Adneocarcinoma colon)

=>Polyps in colon

=>Hemorrhoids ( internal and external)

=>Anal fissures

=>Bleeding ulcers