Ischemic Heart Disease
What is ischemic heart disease?
Ischemic heart disease is a condition of recurring chest pain or discomfort that occurs when a part of the heart does not receive enough blood. This condition occurs most often during exertion or excitement, when the heart requires greater blood flow. Ischemic heart disease, also called coronary heart disease, is common in the United States and is a leading cause of death worldwide.
Ischemic heart disease develops when cholesterol particles in the blood begin to accumulate on the walls of the arteries that supply blood to the heart. Eventually, deposits called plaques may form. These deposits narrow the arteries and eventually block the flow of blood. This decrease in blood flow reduces the amount of oxygen supplied to the heart muscle.
The signs and symptoms of ischemic heart disease may develop slowly as arteries gradually become blocked, or they may occur quickly if an artery suddenly becomes blocked. Some people with ischemic heart disease have no symptoms at all, while others may have severe chest pain (angina) and shortness of breath that can pose a risk of heart attack.
Fortunately, ischemic heart disease can be treated successfully with lifestyle changes, medicines, and surgical procedures. Even better, you can reduce your risk of ischemic heart disease by following heart-healthy practices, such as eating a low-fat, low-sodium diet, being physically active, not smoking, and maintaining a healthy body weight.
Left untreated, ischemic heart disease may lead to severe heart damage. Heart damage can result in heart attack and shock and may be life threatening. Seek immediate medical care (call 911) for serious symptoms, such as difficulty breathing, which may be accompanied by pale or blue lips, rapid heart rate (tachycardia), and severe chest pain. Seek prompt medical care if you are being treated for angina but have mild symptoms that recur or are persistent.
What are the symptoms of ischemic heart disease?
Ischemic heart disease reduces the flow of blood to the coronary arteries, which carry oxygen to the heart. This reduction in blood flow may result in a number of symptoms, which can vary in intensity among individuals.
Common symptoms of ischemic heart disease
You may experience ischemic heart disease symptoms daily or just occasionally. Common symptoms include chest pain, chest pressure, or shortness of breath that:
- Is relieved by rest or medicine
- May feel as if pain starting in the chest spreads to the arms, back, or other areas
- May feel like gas or indigestion (more common in women)
- Occurs repeatedly; episodes tend to be alike
- Occurs when the heart must work harder, usually during physical exertion
- Usually lasts a short time (five minutes or less)
Serious symptoms that might indicate a life-threatening condition
In some cases, ischemic heart disease can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
What causes ischemic heart disease?
Ischemic heart disease is caused by a decrease in blood flow through one or more of the blood vessels that carry oxygen to your heart (coronary arteries). When blood flow is reduced, the heart muscle does not receive the amount of oxygen it needs to function properly.
Ischemic heart disease may develop slowly, as plaque builds up over time, or it may occur quickly if an artery is suddenly blocked. For this reason, ischemic heart disease occurs most frequently in people who have atherosclerosis (buildup of plaque on the walls of the coronary arteries), blood clots, coronary artery spasm, or severe illnesses that increase the heart’s need for oxygen.
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:
- Family history of heart disease
- High blood cholesterol
- High blood pressure
- High blood triglycerides
- Physical inactivity
- Smoking and other tobacco use
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 applicable
- Getting regular physical activity
- Keeping your cholesterol at a healthy 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?
Treatment for ischemic heart disease begins with seeking medical care from your health care provider. To determine if you have ischemic heart disease, your health care provider will ask you to undergo several diagnostic tests.
Medications used to treat ischemic heart disease
Drug therapy is commonly used for treatment of ischemic heart disease and includes:
Angiotensin-converting enzyme (ACE) inhibitors, which relax the blood vessels and lower blood pressure
Angiotensin receptor blockers (ARBs), which lower blood pressure
Anti-ischemic agents such as ranolazine (Ranexa)
Antiplatelet drugs, which prevent the formation of blood clots
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
Many different medicines are available to treat ischemic heart disease. Your health care provider will work with you to select the appropriate medications, depending on your individual condition. It is important to follow your treatment plan for ischemic heart disease precisely and to take all of the medications as instructed.
Surgical procedures used to treat ischemic heart disease
Severe symptoms that are not relieved by medication alone are treated with surgical procedures including:
Angioplasty and stent placement (procedure to remove plaque and restore blood flow in clogged arteries)
Coronary artery bypass graft (procedure that helps restore blood flow to the heart by routing the flow through transplanted arteries)
What you can do to improve your ischemic heart disease
In addition to following your treatment plan, you may be able to improve your ischemic heart disease by:
Carefully managing your diabetes, if applicable
Getting regular physical activity
Keeping your cholesterol at a healthy level
Maintaining normal blood pressure
Quitting tobacco use
Reducing cholesterol and fat in your diet
You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of ischemic heart disease include:
Arrythmia (irregular heart rhythm)
Myocardial infarction (heart attack)