Ischaemic heart disease: What is it?

Written in association with: Dr Francesco Lo Monaco
Published: | Updated: 13/04/2023
Edited by: Karolyn Judge

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.  

 

Man with possible ischaemia holding his chest and with eyes closed in agony

 

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. 

By Dr Francesco Lo Monaco
Cardiology

Dr Francesco Lo Monaco is an award-winning and highly rated cardiologist in London, who has just been recognised for his expertise in clinical cardiology in the European Awards in Medicine/Cardiology category 2022* He is expert in clinical cardiology and cardiac imaging, particularly in echocardiograms, electrocardiograms (ECG), stress tests, palpitations and heart check-ups. Dr Lo Monaco also sees private patients at a range of locations in central and west London including Chelsea and Westminister Hospital, 104 Harley Street, One Welbeck Heart Health as well as at the BMI Syon Clinic in Brentford.

*Dr Lo Monaco is a winner in the European Awards in Medicine 2022. Held every year at the Ritz Hotel in Paris, this prestigious award ceremony celebrates the professional achievements of specialists that have excelled in every field of medicine. Dr Lo Monaco has distinguished himself for his exceptional achievements in clinical cardiology. Read more about his achievement on the European Awards in Medicine website

Dr Lo Monaco qualified in medicine with honours from the University of Pavia, Italy in 1997. He then completed specialist training in cardiology in Milan and worked in the city as a consultant cardiologist for several years. In 2006 he relocated to New York to undergo a postdoctoral fellowship in cardiology at the New York Medical College. During this period, Dr Lo Monaco qualified in medicine in the USA and published ground-breaking research related to cardiac stem cells. He went on to present his findings at 2008’s American Heart Association meeting, held in New Orleans. In 2009, he was appointed as a specialist cardiologist within Chelsea and Westminster NHS Trust. Since then, Dr Lo Monaco has worked at several locations in central London as an associate specialist in cardiology, providing general cardiology care and cardiac imaging services for his patients.

Additional to his clinical work, Dr Lo Monaco is also actively involved in education and has been an honorary senior clinical lecturer and undergraduate tutor at Imperial College London since 2013. He is also an affiliate member of the Royal College of Physicians. In 2022, Dr Lo Monaco's significant contributions to his field were recognised when he won the Cardiology Award at the European Awards in Medicine.

Dr Lo Monaco appreciates that concerns about heart health can be worrying and offers same-day appointments at multiple locations as well as onsite exercise tolerance testing and twenty-four hour ECG Holter Monitor testing for the convenience of his patients. He additionally offers a free initial online consultation to discuss any problems you may experiencing and accepts all types of private health insurance.

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