What is Ischemic Heart Disease?

Ischemic heart disease is defined by an inadequate oxygen delivery to the heart muscle or myocardial cells. This mismatch of oxygen supply and demand through reduced blood flow is one of the most common heart conditions. In layman’s term, ischemic heart disease or myocardial ischemia is called as a heart attack.

Possible Causes

The underlying cause of reduced blood supply to the heart is a narrowed coronary artery. Coronary blood vessels are responsible for supplying oxygen to the entire heart musculature. When these arteries are blocked by fatty material called plaque, ischemic heart disease ensues. This can occur slowly as the plaque builds up and the arteries become progressively narrow, or it can occur suddenly when a plaque completely occludes the vessel. Atherosclerosis is the most commonly implicated disease that leads to plaque build-up and ischemic heart disease. In this condition, increased levels of cholesterol circulating in the blood deposit in the narrow coronary arteries. Other important causes of ischemia include a blood clot originating from other vessels in the body, or a sudden coronary artery spasm.

Risk Factors

Smoking, obesity, diabetes mellitus, hypertension, increased cholesterol and triglyceride levels, and an increased waist circumference increase the risk of developing ischemic heart disease. All of these risk factors lead to fatty deposition in the coronary arteries one way or another.

Signs and Symptoms

The typical signs and symptoms of myocardial ischemia include:

• Severe chest pain that may radiate to the left arm, shoulder or jawline
• Vomiting and nausea
• Sweating
• Palpitations and an irregular heartbeat
• Sudden shortness of breath

Diagnosis

When signs and symptoms of ischemic heart disease arise, the first test that is usually done is an ECG. An ECG will almost always confirm a myocardial ischemia as well as the areas of the heart that have been involved. Blood tests of serum cardiac enzymes are also simultaneously performed to further confirm the diagnosis. When ischemia occurs, certain proteins such as the troponins and creatine kinase leak into the bloodstream which can then be detected through a simple blood test. However, the timing of these tests is important since these cardiac enzymes appear for a limited amount of time in the blood. If the diagnosis remains unclear, a coronary angiogram and echocardiography is performed.

Treatment Options

Treatment for myocardial ischemia should be initiated immediately when the diagnosis is confirmed. Medications for ischemic heart disease include aspirin, nitrates, statins, beta-blockers, and heparin. If the pain is severe, opioids may also be used. The definitive treatment for myocardial ischemia is an angioplasty, stenting or bypass surgery – all of which restore the lost blood flow to the heart.

FAQs

Q. What are the complications of myocardial ischemia?
Complications of ischemic heart disease may occur as quickly as in seconds to as long as weeks to months. Sudden cardiac death and an irregular heartbeat is one of the most feared complications that can occur in the first few hours of diagnosis. Other long-term complications include valvular abnormalities, inflammation around the heart, and congestive heart failure.

Q. What are some lifestyle/home remedies for ischemic heart disease?
Those that have been diagnosed with ischemic heart disease are recommended to make active lifestyle changes. These changes include quitting smoking, losing weight, eating a balanced and a healthy diet, becoming more physically active, and managing stress.

Q. How can you prevent a recurrent heart attack?
Recurrence of myocardial ischemia is fairly common. That is why those with a history of a heart attack are put on a daily aspirin and cholesterol-lowering regime, and any anti-hypertensive drugs such as a beta-blocker in the case of high blood pressure levels. These medications reduce the risk of recurrence. It is also recommended to decrease all sorts of physical activity in the first few weeks after a myocardial ischemia to reduce stress to the heart.