Ischemic Heart Disease

Ischemic Heart Disease

Ischemic Heart Disease (Coronary Artery Disease)

Definition of Ischemic Heart Disease also known as Coronary Artery Disease

Ischemia refers to a lack of oxygen due to inadequate perfusion of the myocardium (muscle of heart), which causes an imbalance between Oxygen supply and demand.

  • The most common cause of myocardial ischemia is obstructive atherosclerotic disease of epicardial coronary arteries.
  • Men develop IHD (Ischemic Heart Disease) earlier than women and death rates are also slightly higher for men than women until the menopause.

Etiology (causes) of Ischemic Heart Disease

  • IHD is invariably caused by disease affecting the coronary arteries, the most prevalent being atherosclerosis accounting for more than 90% cases, while other causes are responsible for less than 10% cases of IHD.
  • Hence, it is convenient to consider the etiology of IHD under following:
    1) Coronary atherosclerosis
    2) Super added changes in coronary atherosclerosis and
    3) Non-atherosclerotic causes.
    Ischemic Heart Disease

Coronary Atherosclerosis

Coronary Atherosclerosis resulting in ‘fixed’ obstruction is the major cause of IHD in more than 90% cases

  1. Distribution – Atherosclerotic lesions in coronary arteries are distributed in 1/more of the 3 major coronary arterial trunks, the highest incidence being in the anterior descending branch of left coronary following right coronary artery.
  2. Location – Atherosclerotic plagues scatter throughout the coronary arterial system.
    -> A significant lesion (sterotic lesions) that may produce chronic myocardial ischemia show that more than 75% reduction in the cross-sectional area of the coronary artery or its branch.
  3. Fixed Atherosclerotic plagues – Atherosclerosis produces gradual luminary narrowing that may eventually lead to fixed coronary obstruction.

Super added changes in Coronary Atherosclerosis

Superimposed changes are

  1. Acute changes in chronic atheromatous plague – Though chronic fixed obstructions are the most frequent causes of IHD, acute coronary episodes are often precipitated by sudden changes in chronic plagues such as plague hemorrhage fissuring or ulceration that results in thrombosis and embolization (artificial formation of embolus) of atheromatous debris.
    -> Acute changes are caused by sudden coronary artery spasm, tachycardia, hyper-cholesterolaemia, etc…
  2. Coronary artery thrombosis – The initiation of thrombus occurs due to surface ulceration of fixed chronic atheromatous plague, ulitmately causing complete luminal occlusion.
  3. Local platelet aggregation and coronary artery spasm – In some cases acute coronary episodes are caused by local aggregates of platelets on the atheromatous plague, short of forming a thrombus.
    -> The aggregated platelets release vasopasmic medications such as thromboxance A2 which may probably be responsible for coronary vasospasm in the already atherosclerotic vessel.

Non-Atherosclerotic causes

Several other coronary lesions may cause IHD in less than 10% cases. These are as under vasospasm, stenosis of coronary ostia, Arthritis, Embolism, Thrombotic diseases, Trauma, Aneurysm compression of coronary.

Coronary artery disease

Risk factors of Ischemic Heart Disease

  1. Age
  2. Being over weight or obesity
  3. Family History
  4. Gender (Men have greater risk than women)
  5. Diabetes
  6. High Cholesterol
  7. Smoking/breathing second hand smoke

Symptoms of Ischemic Heart Disease (Coronary Artery Disease)

  1. Chest pain.
  2. Indigestion or nausea.
  3. Light headed feel or sweating.
  4. Fast heart rate of shortness of breath.

Complications of Ischemic Heart Disease

  1. Arrhythmia (Abnormal heart rhythm)
  2. Heart attack
  3. Heart failure

Treatment of Ischemic Heart Disease

  1. Angioplasty
  2. Self care (weight loss, low fat diet, physical exercise)
  3. Statins, Anticoagulants
  4. Coronary artery bypass surgery

Ischemia – Cause, effect and treatment

Referred the below paragraph from WebMD

The blockage of blood vessels in our body due to any kind of reason leads to a condition called Ischemia. It is most commonly found in the arteries of heart, but it can vary at any part of body, stating, brain, lungs, legs, hands, thighs or anywhere. Due to blockage of the arteries, the effected body part doesn’t get enough oxygen and may lead to severe damage. Such cases can be found on heart, when the Ischemia hits the heart, it may cause heart stroke or attack.

The effect of Ischemia differs on various body parts such as:

  • Brain : Causes stroke.
  • Heart : Causes attack.
  • Legs and hands : peripheral artery disease (PAD), may cause paralysis.
  • Intestines : Ischemia in intestine may cause hole in either small or large intestine, this condition is known as Mesenteric Ischemia.

Treatment for Ischemia : The basic known fact is to have a proper diet and a procedure towards making the blockage open through medicines or subjective machines. Medicines and proper diet will not be an immediate solution but is preferable for longer relief. Reading this basic treatment information. More information will be updated with you soon. Thank you.

Some more related diseases can be found below :
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Hypertension (High Blood Pressure) –
Jaundice –
Tuberculosis –
Gonorrhoea –

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