Ischemic heart disease
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Ischemic Heart Disease, also known as Coronary Artery Disease, is a condition that involves the accumulation of fatty deposits within the cells that line the walls of the arteries. There are two main coronary arteries that lead to the heart and provide its main source of blood. When these arteries are gradually suffused with a slow build-up of fatty deposits, it narrows these blood supply passages in a process known as atherosclerosis.


Atherosclerosis not only impedes the supply of blood to the heart, it also hardens the coronary arteries. Atherosclerosis eventually leads to ischemia, a condition wherein the heart muscle becomes deprived of oxygen-rich blood, which results in damage to the heart muscle and a possible occlusion of the blood vessels. When this occurs, a person may suffer from a myocardial infarction, more infamously known as a heart attack.

There are as many as 4 million Americans who have Ischemic Heart Disease or experience episodes of ischemia without being aware of it. Some cases of ischemia are asymptomatic, and there is a complete absence of pain. These cases are known as silent ischemia, and may give rise to a heart attack without any warning signs at all. Silent ischemia is prevalent among people suffering from angina, those who have had a history of heart attack, or people suffering from diabetes.


Ischemic Heart Disease is one of the most common causes of cardiovascular disease and a leading cause of death in the United States, responsible for nearly 500,000 deaths annually. It affects more men than women and occurs between the ages of 35 and 55 years for both sexes. There are about 14 million people who suffer from Ischemic Heart Disease in the country, and are at a higher risk for contracting angina, myocardial infarction, and sudden death.


Ischemic Heart Disease has been known to develop due to several risk factors such as having high cholesterol levels, diabetes mellitus and smoking. People who suffer from high blood cholesterol or hypercholesterolemia have a higher degree of risk for developing ischemia.

Other risk factors that may cause Ischemic Heart Disease are hypertension, genetic and hereditary factors, menopause, and stress.


Some of the complications arising from this condition include angina pectoris, or angina. This disorder is characterized by chest pain just underneath the breastbone. The pain is a result of a lack of oxygen to the heart caused by the plaque deposits irregularly lining the coronary arteries. Angina pectoris may be mild or intense, lasting up to several minutes at a time. There are approximately 350,000 cases of angina in the United States each year.

A person with Ischemic Heart Disease may also experience acute myocardial infarction, or heart attack. This occurs when the fatty deposits lining the coronary arteries develop a blood clot. This blood clot presents prevents the flow of oxygen-rich blood to the heart, and when this happens, a portion of the heart muscle may die, causing a heart attack. A person who has had a heart attack will bear a scar or fibrosis on the heart muscle, impairing the heart’s blood-pumping ability to some degree.
Ischemic heart disease
Image: Ischemic Heart Disease

Apart from chest pain, other symptoms that accompany Ischemic Heart Disease include back pain, pressure in the chest area, shortness of breath, and extreme fatigue. Pain from angina is usually known to radiate down a person’s left arm, jaw and back. This type of pain is worsened by any form of exercise, but relieved by periods of rest. Usually the pain may be accompanied by excessive sweating.

Other signs that accompany ischemia include obesity, thyroid and vascular disease, anemia, and tendon xanthomas, a thickening in the Achilles tendon.

Ischemia Heart Disease may also result in sudden death, also known as a massive heart attack. Nearly 250,000 people succumb to sudden cardiac death each year. This fatal condition is caused by ventricular fibrillation, an abnormal heart rhythm that renders the heart unable to contract, resulting in a cessation of blood flow to the brain as well as other vital organs of the body. Unless immediate CPR is performed or electric shock delivered via a defibrillator, a person suffering from this condition is likely to die.


The doctor will subject the patient to an exercise stress test while the patient is wearing a Holter monitory. This battery-operated tape recorder is a portable electrocardiogram that reads a person’s heart movements for a period of 24 to 48 hours in order to detect ischemia.

The doctor may also order an echocardiogram to check for any abnormalities in the heart’s chambers and to assess the efficiency of the heart’s pumping action. Myocardial perfusion scanning is also useful in diagnosing ischemia, as is having a coronary angiogram taken to accurately pinpoint the extent and location within the coronary arteries that experience hardening and narrowing.

One other diagnostic tool that makes use of imaging technology is nuclear myocardial imaging, which utilizes radioactive tracers to monitor the journey of the blood towards the heart muscle.


There are various therapies geared at treating Ischemic Heart Disease. Doctors may describe nitrates that work to dilate coronary arteries that have narrowed. When placed under the tongue, they can relieve chest pain in minutes. Other medications, such as Isosorbide Mononitrate and Isosorbide Dinitrate are prophylactics that prevent the occurrence of pain.

Pain relief may also be achieved my reducing the demand for oxygen and decreasing a person’s heart rate through the use of Beta-blockers. Calcium channel antagonists are able to dilate constricted blood vessels, as well as lower a person’s excitability, blood pressure, and cholesterol levels. Daily aspirin intake is known to thin the blood and prevent platelets from forming into blood clots.

Surgery is a last resort option if medical therapy has failed to relieve a person’s ischemia symptoms. This is particularly true if an angiogram result reveals significant levels of blockage in the blood vessels. These surgical procedures include Coronary Angioplasty, a process of dilating a congested blood vessel by inflating a balloon within the blood vessel itself. Coronary Artery Bypass Grafting, meanwhile, involves replacing part of a deceased artery with soft tissue grafted from the patient’s body.


A patient who has been diagnosed with Ischemic Heart Disease will need to make certain lifestyle changes in order to ward off symptoms of ischemia. These lifestyle changes will include avoiding stress, smoking, a high fat diet, and a sedentary lifestyle.
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