Ischemic Heart Disease
Overview
Ischemic heart disease (IHD) is a chronic condition caused by atherosclerosis of the coronary arteries, leading to progressive vessel narrowing and oxygen deficiency for the heart muscle. The disease often manifests as chest pain (angina) during physical exertion, but its most serious risk is a complete artery blockage, leading to a heart attack. Treatment combines strict control of risk factors, medications to improve blood circulation, and, if necessary, invasive procedures such as stenting or bypass surgery.Symptoms
- Shortness of breath and pain while walking
- Chest tightness during excitement
- Chest pain
Ischemic heart disease (IHD), also known as coronary artery disease, is the most common heart disease.
It occurs when the coronary arteries – the blood vessels that supply the heart muscle with oxygen and nutrients – become narrowed and hardened due to the buildup of fatty plaques (atherosclerosis). This narrowing leads to reduced blood flow to the heart muscle, causing ischemia (oxygen deprivation).
Causes and Risk Factors
The main cause is atherosclerosis. The risk factors that accelerate its development are the same as those for hypertension: high cholesterol, high blood pressure (hypertension), diabetes mellitus, smoking, obesity, lack of physical activity, and genetic predisposition. The more risk factors a person has, the higher the chance of developing IHD.
Manifestations and Complications
IHD manifests in various forms:
- Angina (Angina pectoris): The most common manifestation. It is characterized by chest pain or discomfort, usually experienced as heaviness, tightness, or burning behind the breastbone. It is typically triggered by physical exertion or emotional stress and subsides at rest.
- Acute Coronary Syndrome: Includes Unstable Angina and Myocardial Infarction (heart attack). A heart attack occurs when a plaque ruptures and a blood clot quickly forms on it, completely blocking blood flow to a part of the heart muscle, leading to permanent damage.
Diagnosis and Treatment
The diagnosis includes ECG, echocardiography, stress test to assess blood supply during exertion, as well as blood tests for lipid profile and enzymes in case of suspected heart attack. The gold standard for visualizing narrowing is coronary angiography.
The treatment aims to relieve symptoms, slow atherosclerosis progression, and prevent heart attack:
- Lifestyle changes: Strict control of risk factors (quitting smoking, diet, weight control, and blood pressure management).
- Medication therapy: Drugs such as antiplatelet agents (e.g., Aspirin) to thin the blood, statins to lower cholesterol, and beta-blockers or nitrates to relieve angina are used.
- Invasive treatment: Applied in cases of significant narrowing and includes percutaneous coronary intervention (PCI) or stenting (opening the blocked artery with a balloon and placing a stent) or coronary artery bypass graft (By-pass) to create new pathways for blood flow.
Synonyms: Coronary heart disease, Angina pectoris / Chest pain, Coronary arteriography
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