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Ischemia During Exercise

Decreased blood flow to the brain, spinal cord and other parts of the body during exercise. In younger people, this is a warning sign that risk factors may exist for stroke. Symptoms may cease, but underlying problems will not. In older persons, ischemia is often a sign of impending stroke.

Causes

• Excessive exercise, such as prolonged walking or running, that tires the heart and decreases the amount of blood it can pump.
• Excessive rotation or bending of the neck backward or forward, constricting blood vessels in the neck. This may occur occasionally in gymnastics, calisthenics, wrestling, football and yoga.

Underlying conditions that make ischemia during exercise more likely:

• Hardening of the arteries.
• Cervical spondylosis (degenerative changes in bones of the neck, causing pressure on nerves, blood vessels and muscles).
• Congenital anatomic abnormalities in blood vessels to the brain (aneurysms, for example).
• High blood pressure.
• Diabetes mellitus.
• Obesity.
• Family history of strokes.

Signs and symptoms

• Dizziness or falling.
• Leg pain brought on by exercise and relieved by rest.
• Impaired gait or legs "giving out."
• Nystagmus (irregular, involuntary movement of the eyes).
• Vomiting.
• Speech impairment.
• Partial, temporary or permanent paralysis of arm, leg and neck muscles on one or both sides.
• Diminished vision.
• Breathing difficulty.

Diagnosis

• X-rays of the head and spine.
• CAT scan of the brain and spinal cord.

Treatment

Medical Treatment

• Consult your doctor after the first incident of ischemia, even if symptoms disappear. Diagnosis of the underlying cause is essential.
• Hospitalization and surgery may be necessary to correct serious underlying disorders.
• If ischemia leaves residual disability, physical therapy will be helpful until recovery is complete.

Home Treatment- No self-treatment. Seek emergency professional care for any sign of ischemia.

Medication- Your doctor may prescribe anticoagulants such as warfarin, aspirin or others.

Prevention

• Try to avoid specific exercises or activities that bring on ischemia.
• Follow measures to prevent hardening of the arteries:
  Don't smoke.
  Reduce stress to a manageable level.
  Follow a low-fat, low-salt, high-fiber diet. Maintain your ideal weight.
• If you have diabetes or high blood pressure, adhere rigidly to your treatment program to keep it under control.
• If you are over 40, ask your doctor about taking 1 aspirin tablet daily to decrease the likelihood of platelet-clumping.