Ischaemic heart disease: What is it?

Ischaemia, also known as ischaemic heart disease, is a condition in which the heart lacks oxygen due to reduced blood flow in the coronary arteries.

Here to discuss this condition in depth is leading associate cardiology specialist, Mr Francesco De Lo Monoco.  

What is ischaemic heart disease?

It’s a condition where the heart is starved of oxygen due to a lack of blood flow, also known as ischaemia. A build-up of plaque, or fatty materials plus cells, in the wall of one of coronary arteries, which provide blood to the heart, is the main reason why ischaemia occurs. The heart is deprived of oxygen and nourishment as it grows larger in mass, as plaque gradually obstructs blood flow.

Sometimes the cardiac cells cease working and die because they are deprived of blood and oxygen, due to the plaque tearing from the artery and rupturing. Chest pain, malignant irregular heartbeats, complete heart failure, or even death can occur due to a myocardial infarction (heart attack).

What are the symptoms of ischaemic heart disease?

Chest pain (referred to as angina), sweating, fatigue, and shortness of breath are the most prevalent symptoms of ischaemic heart disease. 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 doctor if pain should dramatically worsen or increase over a short period of time. 'Silent' ischaemic heart disease, where symptoms don’t present at all, sometimes occur.

What are the causes of ischaemic heart disease?

While ischaemic heart disease can be caused by many pre-existing conditions, it can also be caused by several external factors, including:

• Smoking
• Alcoholism
• Diabetes
• High blood pressure
• High cholesterol

Ischaemic heart disease risk factors increase with age, weight gain, and physical inactivity. Also, people with other heart conditions, high triglycerides and auto immune diseases, or sleep apnoea, are predisposed to the condition. Ischaemic heart disease can be kept at bay with discontinued use of alcohol, smoking, or fatty foods, as well as incorporating a healthy lifestyle, even though in many cases it cannot be reversed or prevented entirely. Your doctor might recommend switching to a low fat, low carb, low salt diet to reduce further health complications.

How is ischaemic heart disease diagnosed?

Your doctor may send you for a variety of tests if ischaemic heart disease is suspected. These diseases include:

• 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 a stationary bike or elliptical.
• An echocardiogram test, where an ultrasound is taken of your chest to produce video images of your heart.

At the recommendation of your doctor, the tests can be taken as various steps of your diagnosis. 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 after treatment.

How is ischaemic heart disease treated?

Ischaemic heart disease treatment, with the goal of increasing the blood flow supply to your heart, therefore improving the strength of your heart muscle, can come in various forms.

A variety of medicines may be prescribed by your doctor. It can range from aspirin, which reduces your risk of blood clots, or more tailored to your particular situation, such as:

• Cholesterol-lowering medications;
• Nitrates;
• Angiotensin-converting enzyme; or
• Calcium-channel blockers.

Several procedures to improve heart health and blood flow you can undergo, include, but aren’t 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.

If you'd like a consultation regarding ischaemic heart disease or other cardiology issues, arrange an appointment with Mr Lo Monoco via his Top Doctors profile.