Ischemic heart disease is the most common heart disease, and occurs when blood flow to the heart muscle is reduced due to a partial or complete blockage of the arteries that supply blood to the heart muscle.
Ischemic heart disease, a very common disease in cardiology, can damage the heart muscle, reducing its ability to pump efficiently. A sudden and severe blockage of a coronary artery can lead to a heart attack.
Risk factors for ischemic heart disease
Factors that may increase the risk of developing myocardial ischemia include smoking, family history, hypertension, obesity, diabetes, lack of exercise, high cholesterol, and stress.
Symptoms of ischemic heart disease
In most people the first symptoms may take decades to appear. These are:
- Angina pectoris. This is pressure or pain in the chest (usually on the left side) that occurs regularly with physical activity or after heavy meals.
- Pain in the neck or jaw.
- Pain in the shoulder or arm
- Shortness of breath
- Sweating
- Decreased exercise tolerance
Heart attack, the most serious complication
If an artery becomes completely blocked, the lack of blood and oxygen can lead to a heart attack, which will destroy part of the heart muscle. When this happens, the electrical impulses that coordinate the heartbeat may not work properly, causing the heart to beat irregularly, faster or slower. In some cases, arrhythmias can be life-threatening.
Myocardial ischemia can damage the heart, reducing its ability to effectively pump blood to the rest of the body. This can lead to heart failure.
Causes of ischemic heart disease
Myocardial ischemia is caused by plaque that forms along the inner walls of the coronary arteries, which supply blood to the heart, narrowing them and reducing blood flow to the heart muscle, i.e., decreasing the amount of oxygen the heart muscle receives. This process is known as atherosclerosis.
The coronary arteries can also become blocked by a blood clot, which can completely block the blood supply to the heart and cause a heart attack, or by vasospasm (Prinzmetal’s angina), a narrowing of the coronary arteries caused by contraction of the smooth muscle of the vessel wall. Spasms of these arteries can also occur in people suffering from diseases that affect the immune system, such as lupus.
Ischemic heart disease can occur slowly, as arteries become clogged over time, or rapidly, when an artery is suddenly blocked.
Diagnosis and treatment of ischemic heart disease
A review of the clinical history is necessary, as well as a complete physical examination and a series of tests including: electrocardiogram, echocardiography, stress test, nuclear medicine, coronary CT scan and coronary angiography.
As for treatment, this involves making lifestyle changes such as taking medications and possibly undergoing surgical procedures.