What Is Ischemic Heart Disease?
Ischemic heart disease, also known as coronary heart disease, is a term that refers to problems caused by reduced blood flow in the heart arteries.
This is a very common problem, one that’s known to affect men more than women. We’ll review its symptoms, causes, diagnosis, and options in order to address it according to its severity.
The characteristics of ischemic heart disease
The term ischemia is used in clinical contexts to refer to the incomplete supply of blood to a certain area due to the obstruction of the blood vessels. In very simple terms, it means that an organ isn’t receiving enough oxygenated blood because the blood supply to it is inefficient.
Therefore, when speaking of ischemic heart disease, reference is made to a deficient blood supply to the heart muscle. It’s commonly used synonymously with coronary artery disease; although strictly speaking, they’re not the same.
Indeed, and as we’ll see later, a poor blood supply to the heart can have different causes, not just the narrowing of the coronary arteries.
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Ischemic heart disease doesn’t always appear with obvious symptoms and signs. In fact, the American Heart Association warns that silent episodes are very common. People who’ve had heart attacks in the past and those who currently have diabetes are more likely to develop silent episodes.
The symptoms of ischemic heart disease
The most common manifestations of ischemic heart disease are angina pectoris and acute myocardial infarction. Angina pectoris is pain caused by the reduced blood supply to the heart muscle. Normally, it occurs due to the partial occlusion of one or several coronary arteries.
Angina usually manifests itself in specific situations, at least when it develops in a stable pattern. Most of the time, the patient will experience the symptom when performing a physically demanding activity.
Even so, and in case of developing unstable angina, you can also do it when you’re at rest. These latter cases are usually classified as acute coronary syndrome. Angina pectoris can cause pain in the following areas:
- Jaw
- Shoulders
- Back
- Clavicle
- Arms
In addition to being more common in contexts of physical exertion, they’re also common in situations of emotional stress. It’s important to note that it’s not a symptom that’s exclusive to this condition, as it can also appear in uncontrolled hypertension, valvular disease, hypertrophic cardiomyopathy, and many others. Chest pain is often accompanied by the following:
- Difficulty breathing
- Acceleration of heart rate
- Nausea and vomiting
- Increased sweating
- Loss of consciousness (in severe cases)
Fatigue is also relatively common, as it’s a hallmark symptom. As we’ve already warned, the silent manifestation of the condition isn’t uncommon. Therefore, you can have ischemic heart disease without manifesting any obvious symptoms.
The causes of coronary heart disease
We’ve already mentioned one of the main causes of CHD: Coronary artery disease. The latter generates a narrowing of the arteries that supply the heart, which translates into a reduction in blood flow.
At the same time, and as researchers warn, heart ischemia often appears in cases of calcified arteriosclerosis. This is the accumulation of plaque in the arterial wall.
It can also appear as a consequence of a blood clot, which partially or totally limits the blood supply to the heart. We’ll highlight the following risk factors that influence its development:
- Suffering from hypertension (especially when it’s not controlled)
- Maintaining a sedentary lifestyle
- Sticking to an unbalanced diet
- Having diabetes (especially when it’s not controlled)
- Being obese
- Smoking
There are other risk factors that may have a certain impact on its development, which include major depression, alcohol abuse, and air pollution, to name a few. Lastly, we know that the condition can be triggered by endothelial dysfunction, microcirculatory dysregulation, coronary vasospasm, and other coronary abnormalities.
The diagnosis of ischemic heart disease
Experts recommend noninvasive anatomical or functional imaging tests to diagnose cardiac ischemia. Before doing so, the doctor will make a general evaluation of the patient in which they’ll take into account the patient’s personal and family history.
They may also order blood tests and will proceed with a physical exam. The most used imaging evaluations are the following:
- Electrocardiogram
- Echocardiogram
- Stress test
If the doctor sees fit, they may also perform a coronary angiography. It’s considered in patients with a very high-risk factor or when the previous tests haven’t yielded complete results for a sure diagnosis. The intervention isn’t recommended for low-risk patients.
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Treatment options
The treatment of ischemic heart disease depends on the findings in the diagnostic process. In any case, a comprehensive approach will be chosen. Therefore, associated risk factors, related underlying medical conditions, lifestyle changes, and drug therapy will be taken into account.
First of all, the doctor will recommend a change in life habits: Improving diet, losing weight, quitting smoking, reducing alcohol intake, and exercising, among other things.
In the same way, it’s important to control stressful situations and emotional disturbances of any other type. Doctors may suggest that patients with depression or anxiety seek professional help.
At the same time, patients must adhere to treatments for underlying conditions or, if they aren’t currently undergoing treatment, the doctor will evaluate necessary measures. It’s very important to control hypertension, dyslipidemia, and diabetes. Regarding medications to control the condition, the doctor may prescribe any of the following:
- Antiplatelets
- Beta-blockers
- Calcium channel blockers
- Renin-angiotensin-aldosterone blockers
- Lipid-lowering agents
These drugs not only address some factors that mediate the progression of the condition, but also control the symptoms. Again, the choice is made based on the result of the diagnostic process. Schedule a visit with your doctor to evaluate your state of health and choose a personalized therapy.