What is ischemia?Ischemia is a condition in
which the blood flow (and thus oxygen) is restricted or reduced in a
part of the body. Cardiac ischemia is the name for decreased blood flow
and oxygen to the heart muscle.
What is ischemic heart disease?It's
the term given to heart problems caused by narrowed heart arteries.
When arteries are narrowed, less blood and oxygen reaches the heart
muscle.
Ischaemic Heart Disease (coronary artery disease or CAD) is a condition in
which atheroma (fatty deposits) builds up in the linings of the walls of the
coronary arteries. This causes a narrow artery and reduced blood flow to the
heart muscle. This process can occur in other arteries of the body. Important
arteries which, if affected can have medical consequences, are the carotid
arteries in the neck, (which supply blood to the brain), and the femoral /popliteal
arteries in the legs. In these situations a bruit (noise) may be heard over
the area affected (i.e. carotid or femoral arteries), through a stethoscope.
Signs and symptoms
- Angina pectoris (chest pain on exertion, in cold weather or emotional situations)
- Acute chest pain: acute coronary syndrome, unstable angina or myocardial infarction ("heart attack", severe chest pain unrelieved by rest associated with evidence of acute heart damage)
- Heart failure (difficulty in breathing or swelling of the extremities due to weakness of the heart muscle)
- Heartburn
Management
In stable IHD, antianginal drugs may be used to reduce the rate of occurrence and severity of angina attacks. Treatments for acute coronary syndrome and established coronary artery disease is discussed above in "diagnosis". Revascularization for acute coronary syndrome has a significant mortality benefit, Recent evidence suggests that revascularization for stable ischaemic heart disease may also confer a mortality benefit over medical therapy alone.Treatment of coronary artery disease includes addressing "modifiable" risk factors. This includes suppression of cholesterol (usually with statins), even in those with statistically normal cholesterol levels, control of blood pressure, blood sugars (if diabetic), and regular exercise. Smokers are encouraged to stop smoking. Diet plays a major role in the progression of coronary artery disease and by making certain diet choices a person can drastically change their chance of dying from it
