Dr Lo Monaco
Ischaemia, also known as ischaemic heart disease, is a condition in which the heart is starved of oxygen due to a lack of blood flow. This is frequently caused by a build-up of plaque (fatty material plus cells) in the wall of one of the coronary arteries, which provide blood to the heart.
The plaque gradually obstructs blood flow, depriving the heart of oxygen and nourishment as it grows larger in mass.
Sometimes, the plaque can tear from the artery and rupture, which means the cardiac cells cease working and die because they are deprived of blood and oxygen. A myocardial infarction (heart attack) can occur, causing chest pain, malignant irregular heartbeats, complete heart failure, or even death.
The most prevalent symptoms of ischaemic heart disease are chest pain (referred to as angina), sweating, fatigue, and shortness of breath. Other symptoms include:
- Shoulder/arm pain
- Neck/jaw pain
- Nausea and vomiting
Symptoms may worsen as time progresses, or appear in a variety of forms, but the important part to remember is to contact your Cardiologist if pain should dramatically worsen or increase over a short period of time. Sometimes, symptoms do not present at all, referred to as silent ischaemic heart disease.
While ischaemic heart disease can be caused by manypre-existing conditions, it can also be caused by several external factors, including:
- Smoking
- Alcoholism
- Diabetes
- High blood pressure
- High cholesterol
Risk factors for ischaemic heart disease increase with age, weight gain, and physical inactivity. People with sleep apnea, autoimmune diseases, high triglycerides, or other heart conditions are predisposed to the condition. Though in many cases it cannot be reversed or prevented entirely, ischaemic heart disease can be kept at bay with discontinued use of alcohol, smoking, or fatty foods, as well as incorporating a healthy lifestyle. Your doctor might recommend switching to a low fat, low carb, low salt diet to reduce further health complications.
If ischaemic heart disease is suspected, your doctor may send you for a variety of tests including:
- An electrocardiogram (ECG), where electrodes are attached to your chest and record the electrical activity of your heart
- A coronary angiogram, where a dye is injected into the blood around your heart and x-rays are taken to show the path the dye takes
- A cardiac CT scan, to determine if there is a build-up of calcium in your coronary arteries
- A stress test, where your vitals like heart rate, blood pressure, and breathing are monitored while you walk a treadmill or ride stationary bike or elliptical.
- An echocardiogram test, where an ultrasound is taken of your chest to produce video images of your heart.
The tests can be taken as various steps of your diagnosis, at the recommendation of your doctor. These tests are important to assess whether you have had a heart attack in the past or whether you have blocked arteries and to assess the strength of the muscle before and aftertreatment.
Treatment for ischaemic heart disease can come in various forms, all with the goal of increasing the blood flow supply to your heart, therefore improving the strength of your heart muscle.
Your doctor may prescribe a variety of medications, some as simple as aspirin (which reduce your risk of blood clots), or more tailored to your particular situation, like cholesterol-lowering medications, nitrates, angiotensin-converting enzyme, or calcium channel blockers.
There are also several procedures you can undergo to improve heart health and blood flow, including, but not limited to:
- Angioplasty, in which a tube is inserted into the blocked artery to allow for the implantation of a balloon or stent to widen it
- Coronary artery bypass surgery, in which a graft is constructed from another part of your body to allow blood to flow around the blocked arteries.