Ischaemic (or ischemic) heart disease, also called as myocardial ischaemia, is characterized by reduction in blood supply (ischaemia) to heart muscle. It usually runs in families. It is more common in men. Risk factors are older age, smoking, diabetes, high cholesterol, and high blood pressure. It usually results due to gradual build-up of fat and cholesterol in the arteries supplying blood to heart, narrowing their lumen. Most typical symptom is chest pain (angina).
If heart attack and heart failure result, then their symptoms will be present. Other complications are stroke, aneurysm, peripheral artery disease, and sudden cardiac arrest, which can be fatal. Treatment is with lifestyle changes, medications, and sometimes surgery.
Causes Of Ischaemic Heart Disease
Ischaemic heart disease occurs due to gradual build-up of cholesterol and cell debris on the walls of arteries (atherosclerosis) supplying blood to the heart. The lumen of arteries is narrowed, interfering with blood supply to heart. The following factors favour the process of atherosclerosis.
High Cholesterol
Liver makes the cholesterol and it is carried by blood to all parts of the body. HDL and LDL are the lipoproteins that bind to cholesterol and carry it around in the blood stream. It is the high levels of LDL (“bad”) cholesterol in your blood that leads to atherosclerosis.
High Blood Pressure
Normal blood pressure (BP) is approximately 120/80 mm Hg. If the diastolic BP (lower value) is over 90 mm Hg, then you are said to have high BP. High BP damages the inner lining of arteries, and thus makes it easier for cholesterol and other cell debris to lodge in such areas on the walls of arteries.
Smoking
Smoking is one of the major risk factors for this disease. In fact, the risk of this disease in a smoker is 24% higher. There are several chemicals present in cigarette smoke, such as nicotine and carbon monoxide, which damage the walls of arteries and increase the likelihood of atherosclerosis.
Diabetes
Diabetes (high blood sugar) doubles your risk for ischaemic heart disease. Diabetes increases the thickness of the inner lining of blood vessels. This tends to narrow the lumen of coronary arteries. As a consequence, the heart receives less blood supply, leading to the disease.
Symptoms Of Ischaemic Heart Disease
Chest Pain (Angina)
Chest pain is by far the commonest symptom of this disease. It occurs on account of reduced blood supply to heart muscle, which reduces the supply of oxygen to the contracting heart muscle. It may be felt as frank pain, or as tightness or heaviness in the chest. The pain usually occurs on exertion.
Heart Attack
If the blockage of coronary arteries is very significant it can cause heart attack. You will have chest pain, accompanied by sweating, nausea, lightheadedness and breathlessness.
The chest pain may radiate to left arm, neck and jaw. The pain can occur even at rest and usually lasts for more than 15-30 min. Unlike angina, it is not relieved by nitrate spray or tablet.
Heart Failure
The heart can become weak and unable to pump blood properly to the rest of the body. This leads to build-up of fluid in the lungs, leading to breathlessness. Fluid can accumulate in the legs, leading to swelling of feet. This can happen suddenly or gradually.
Treatment Of Ischaemic Heart Disease
Lifestyle Changes
Stop smoking if you are currently a smoker. Exercise regularly and avoid a sedentary lifestyle. Eat a diet that is low in fat and high in fiber. Deal effectively with stress by doing relaxation exercise and yoga.
Medications
You need to get proper medication for high blood pressure and diabetes, if you have them. If your cholesterol is high, you need to take statins. Nitrates can relieve the chest pain by dilating the blood vessels and increasing the blood flow.
Procedures And Surgery
Some cases are severe or do not respond to lifestyle changes and medications. There are some procedures and surgeries to deal with such cases. They include angioplasty and stenting, coronary artery bypass, and even heart transplant.
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