Ischemic heart disease is also known as coronary heart disease and represents a condition in which cholesterol deposits attach the inner lining of the artery walls, causing them to become narrow over time. As these deposits start forming plaques, they can eventually lead to blood clot formations that completely block the coronary arteries. This cuts the blood supply to the heart, which can in turn cause a heart attack.
Symptoms of ischemic heart disease
As with every other type of heart disease, this one can also manifest different kinds of symptoms from one person to another. Even the same symptom, such as angina, is experienced differently from one individual to another.
Causes of ischemic heart disease
There are many different causes of ischemic heart disease, but first, it’s important to recognize the three main types:
- Obstructive coronary artery disease. This occurs when plaque formations narrow the coronary arteries further and further, leading to an obstruction of at least 50 percent. People who have obstructive coronary artery disease are also more likely to end up having one of the three large coronary arteries permanently blocked.
- Nonobstructive coronary artery disease. This type of ischemic heart disease is specific to those who have narrow coronary arteries but not as narrow as they are in people with obstructive coronary artery disease. It is estimated that about 20 to 50 percent of the people who are tested for coronary artery disease have this type of problem.
- Coronary microvascular disease. People who have coronary microvascular disease are basically experiencing problems with their smaller arteries. It can occur alone but sometimes happens together with obstructive or non-obstructive coronary artery disease. This condition is mostly due to the changes that occur in the microvascular system, causing blood flow restriction to the heart through the smaller arteries.
Diagnosis of ischemic heart disease
The most common tests used to diagnose this condition include:
- Electrocardiogram. A non-invasive test that observes the electrical impulses of your heart, to determine whether or not your heartbeat at an abnormal rhythm.
- Echocardiogram. A sonogram of your heart that renders digital images on a monitor. This helps the doctor get a clear view of your heart, determine whether or not there are blood flow restrictions in your coronary arteries.
- Blood tests to see if your limit panel is within the normal range, which can help determine your current cholesterol levels. These tests will also determine your blood sugar levels.
- Cardiac computed tomography. Typically preceded by X-ray tests, this will show if you have coronary artery disease.
- Cardiac magnetic resonance imaging can help determine if there are any tissue damage or blood flow restrictions. It helps determine if you have an obstructive, non-obstructive, or coronary microvascular disease. It’s a test that usually follows a CT scan or a chest X-ray.
- Cardiac positron emission tomography scan. It’s used to determine how the blood flows through the small arteries, through the help of radioactive tracers (it’s a type of nuclear heart scan).
- Coronary calcium scan. Since calcium is one of the ingredients inside the plaques that lead to coronary artery disease, a calcium scan can help doctors measure how much calcium is currently found in the walls of your coronary arteries.
- Coronary angiography. A type of test that involves injecting a special dye inside your coronary arteries, to get a better view of how blood flows through your arteries.
- Coronary guidewire sensor technology. A test that helps assess the microvascular function of your heart. By using a catheter, the doctor inserts a guidewire in your coronary arteries to see if there is any elevated blood pressure.
Treatment of ischemic heart disease
These changes include a balanced diet (with as little cholesterol and fat as possible), quitting smoking, and engaging in physical exercise. You will also be required to manage your stress levels and make sure that you gain weight (obese people will also have to lose weight).
Since ischemic heart disease is the result of elevated blood pressure, high cholesterol levels, or diabetes, doctors may be required to prescribe medications for these problems.
Prescription drugs include:
- Ace inhibitors to treat hypertension.
- Beta blockers and calcium channel blockers to reduce blood pressure and make sure the heart doesn’t overload trying to pump missing blood.
- Nitrates, which are used to relieve chest pain.
- Medication to control blood sugar levels.
- Statins and other cholesterol-lowering medication.
Three main procedures may be employed if you're experiencing severe ischemic heart disease:
- Percutaneous coronary intervention. This procedure opens the coronary arteries and potentially involves inserting a permanent stent to keep the arteries open.
- Transmyocardial laser revascularization. This intervention is for people who suffer from chest pain caused by ischemic heart disease, and who can’t follow another treatment path.
- Coronary artery bypass grafting. An open-heart procedure that requires taking healthy vessels from a body part and using it to reroute the blood flow to the heart past the blockage in the coronary arteries.
Once you have been diagnosed with ischemic heart disease, you will have to take precautions throughout your entire life. While immediate danger may be removed, lifestyle changes are permanent, and include healthy eating and exercising on a regular basis.