Ischemic Heart Disease: Symptoms, Causes, and Treatments

Medically Reviewed By Dr. Payal Kohli, M.D., FACC
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Ischemic heart disease is chest pain or discomfort that recurs when part of the heart muscle does not receive enough blood. “Ischemic” means a body part is not getting enough blood flow and, thus, oxygen. Plaque buildup on the walls of the coronary arteries causes ischemic heart disease. Symptoms of ischemic heart disease occur more often during periods of excitement or physical exertion but can also occur suddenly and without warning.

Treatment may include lifestyle changes, medications, and sometimes surgery. 

This article looks at ischemic heart disease and its symptoms, causes, and treatments. Read on to learn ways you can lower your risk of this form of heart disease.

What is ischemic heart disease?

Coronary heart disease and coronary artery disease are more common names for ischemic heart disease.

According to the Centers for Disease Control and Prevention (CDC), ischemic heart disease is the most common form of heart disease in the United States. It is also the leading cause of heart attack.

This disease most often occurs when cholesterol particles in the blood build up on the walls of the arteries that supply blood to the heart muscle. Eventually, deposits called plaques may form. These plaques are a result of inflammation.

These deposits cause the arteries to narrow. This narrowing can block the flow of blood. This reduces the amount of oxygenated blood reaching the heart muscle. This process is called atherosclerosis.

What does “ischemic” mean?

“Ischemic” means a body part is not getting enough blood flow and, because of this, not enough oxygen. When this happens to the heart, it is called ischemic heart disease. This disease is also known as coronary heart disease and coronary artery disease.

If you have ischemic heart disease, you may have chest pain or discomfort during exertion or excitement. These are times when the heart requires greater blood flow. “Angina” is the name for this type of chest pain.

The signs and symptoms of this disease may develop slowly as plaques gradually block the arteries. However, sometimes the symptoms arise quickly if an artery suddenly becomes blocked.

Some people with ischemic heart disease have no symptoms at all. This is called “silent ischemia.”

A heart attack can be the first sign of a problem for someone who has silent ischemia. Other people may first have severe chest pain and shortness of breath. 

Lifestyle changes, medications, and sometimes surgery can successfully treat ischemic heart disease.

You can reduce your risk of this disease by following heart-healthy practices. This includes eating a low-fat, low-sodium diet, being physically active, not smoking, and maintaining a moderate body weight.

Left untreated, ischemic heart disease can cause a heart attack. Seek immediate medical care (call 911) for serious symptoms, such as severe chest pain, difficulty breathing, dizziness, fainting, pale or blue lips, or rapid heart rate. 

Seek prompt medical care if you are being treated for angina but have symptoms that recur, worsen, or are persistent even at rest.

What are the symptoms of ischemic heart disease?

Ischemic heart disease decreases the amount of blood flowing through the coronary arteries. These arteries carry oxygen-rich blood to the heart muscle.

Reduced blood and oxygen to the heart can cause varying symptoms. Symptoms can differ from person to person.

Common symptoms of ischemic heart disease

You may have ischemic heart disease symptoms daily, just occasionally, or not at all. When symptoms occur, common symptoms include chest pain, chest pressure, or shortness of breath that:

  • may feel as if pain, pressure, heaviness, or tightness starting in the chest is spreading to the arms, back, or other areas
  • may feel like gas or indigestion
  • occur repeatedly in similar episodes
  • occur when the heart must work harder, usually during physical exertion
  • subside with rest or medicine
  • usually last a short time, about 5 minutes or less

Serious symptoms that might indicate a life threatening condition

Ischemic heart disease can cause a heart attack. Seek immediate medical care (call 911) for any of these serious symptoms, including:

What are the causes of ischemic heart disease?

In ischemic heart disease, narrowing coronary arteries reduce the amount of oxygenated blood flowing to the heart muscle. Without enough blood flow, the heart muscle does not receive the amount of oxygen it needs to function properly.

Ischemic heart disease occurs most often in people who have atherosclerosis. This is a buildup of plaque on the walls of the coronary arteries. However, the reduced blood supply can also be due to blood clots, coronary artery spasms, or severe illnesses that increase the heart’s need for oxygen. 

What are the risk factors for ischemic heart disease?

A number of factors increase the risk of developing ischemic heart disease. Not all people with risk factors will get ischemic heart disease. Risk factors for ischemic heart disease include:

Reducing your risk of ischemic heart disease

You may be able to lower your risk of ischemic heart disease by:

  • carefully managing your diabetes if you have the condition
  • getting regular physical activity
  • keeping your cholesterol below the target level
  • maintaining normal blood pressure
  • quitting smoking and other tobacco use
  • reducing the amount of cholesterol and fat in your diet

How is ischemic heart disease treated?

This section discusses medications and procedures that treat ischemic heart disease as well as lifestyle changes that can improve this condition.

Medications to treat ischemic heart disease

Drug therapy is a common treatment for ischemic heart disease and includes:

  • angiotensin-converting enzyme inhibitors, which lower blood pressure and relax blood vessels
  • angiotensin receptor blockers, which lower blood pressure and relax blood vessels
  • anti-ischemic agents, such as ranolazine (Ranexa)
  • antiplatelet drugs, which prevent blood clots from forming
  • beta-blockers, which lower the heart rate
  • calcium channel blockers, which reduce workload on the heart muscle
  • nitrates, which dilate the blood vessels
  • statins, which lower cholesterol

There are several medications within each class of drugs to treat ischemic heart disease. Your doctor will work with you to pick the best ones for your situation.

Tell your doctor if you are having problems with your medications, such as side effects. It is likely that your doctor can find an alternative medicine that may work better for you.

Procedures to treat ischemic heart disease

If medicines alone are not enough to relieve severe symptoms, your doctor may recommend a coronary angioplasty and stent placement procedure or a coronary artery bypass graft (CABG) surgery.

Coronary angioplasty and stent placement is a catheter-based procedure to remove plaque and restore blood flow in clogged arteries.

CABG is a surgery that helps restore blood flow to the heart by routing blood flow through transplanted arteries.

What you can do to improve your ischemic heart disease

In addition to medicines and procedures, you may be able to improve your ischemic heart disease with lifestyle changes. These are the same healthy habits that may help reduce the risk of ischemic heart disease.

What are the potential complications of ischemic heart disease?

Possible complications of ischemic heart disease include:

Summary

Ischemic heart disease, also known as coronary artery disease, is the most common heart condition in the U.S. It is also the main cause of heart attack.

The disease most often results from atherosclerosis, which is a buildup of fatty plaques inside the heart’s arteries.

These deposits reduce blood flow and oxygen supply to the heart muscle. Heart-healthy living is important for both the prevention and treatment of this potentially life threatening disease.

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Medical Reviewer: Dr. Payal Kohli, M.D., FACC
Last Review Date: 2022 Jan 30
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