Ischaemic Heart Disease

Ischaemic heart disease arises when the heart is not adequately provided with blood resulting in substantial damage to the heart muscle. Consequently the heart muscle does not operate efficiently. The narrowing of the arteries from an accumulation of plaque is responsible for the restriction of blood flow. The cause of the disease is not known but there are risk factors that increases the possibility of acquiring the disease. It is very widespread in the United States and is considered to be the leading cause of death in western countries.

Signs and Symptoms

At the inception of the disease it is likely to be asymptomatic.

Angina pectoris and heart failure will be the major symptoms experienced by an afflicted individual.

Angina Pectoris

Angina Pectoris or chest pain is observed in times of in cold weather conditions, emotional distress and during physical activity. It may extend from the chest area to the jaw, left arm, shoulder blades, neck. There are cases of ischaemia that will not produce any type of angina attacks and in those cases it is designated silent ischaemia.

Heart Failure

Heart failure may occur because of ischaemic heart disease. This may show symptoms like: shortness of breath or difficulty breathing which increases during exercise or when lying flat; oedema or swelling of the ankles; persistent coughing and decreased ability to perform usual actives.

Risk Factors

Though the true cause of Ischaemic heart disease has not yet been identified, there are some factors that generally increase the possibility of developing the disease.

• Indulging in cigarette smoking.
• Having a family history of other conditions may greatly increase the risk of developing the disease. Diseases may include: hypertension, diabetes, coronary artery disease, and atherosclerosis.
• Consuming a diet in fat or one that does not provide the right nutrients
• Having high cholesterol levels; specifically a low level of good cholesterol and high level of bad cholesterol.
• Having previously suffered a heart attack or stroke.
• Being greatly overweight or obese.
• Leading a high stress lifestyle.
• Leading a sedentary lifestyle which does not include regular exercise.
• Suffering from high blood pressure or hypertension
• Being diabetic

Diagnosing and Treating the Disease

Diagnostic tests

After experiencing chest pain, tests will be performed to confirm if the pain is as a result of an angina attack. An electrocardiogram or ECG may be utilized to observe and analyse the changes that are produced during an attack. A dose of sublingual nitroglycerin may be administered that relieves the correlating pain of angina in minutes. These testing methods will confirm if these attacks are actually angina attacks.

Other tests may be performed to discern the severity of ischaemia and also to identify possible coronary artery disease. The tests will normally be completed using coronary angiogram, electrocardiogram (ECG), echocardiogram, x -rays of the chest, thallium stress test, cholesterol and blood tests to analyse total fat, lipoproteins and cholesterol levels and or exercise tolerance test.

Treatments

• Smoking should be eliminated as it will only worsen the condition.
• Hypertension or high blood pressure may need to be controlled with medication and a low sodium diet.
• Cholesterol levels should be managed with the appropriate drugs.
• It will necessitate a change in diet that will determine the how much and what types of foods should be consumed.
• Maintaining an ideal body weight will be essential.
• Exercising at least three times per week will be promoted.
• Stress management and reduction will be beneficial.
• A balloon angioplasty may be utilized in the treatment of the disease. Asmall uninflated balloon will be passed up the affected artery and inflated to free the hindrance. Though this type of treatment will lessen the corresponding symptoms of the disease it will not control the progression of the disease.
• Bypass surgery may be performed in very serious cases.
• Treatment may also involve the use of medications such as nitrates, calcium channel antagonists, beta blockers and anti-platelet drugs. Beta blockers will reduce the heart rate when resting thus lowers the demand for oxygen. Nitrates will stop an angina attack. Calcium channel blockers will prevent blood vessel constriction and subsequently prevent artery spasm. Anti- platelet drugs like aspirin will not allow platelets to stick to blood vessel walls therefore decreasing the chance of further narrowing of the vessels.
• If the disease has reached a stage where it is beyond repair or when normal treatment is not effective then a heart transplant may be performed.

Prognosis

If treatment begins before serious damage to the heart occurs then the forecast is generally fair. Adopting a beneficial lifestyle will greatly improve quality of life and longevity. It is possible for aggressive treatments to inhibit the progress of the disease and repair some of the damage to the heart. The long term prognosis for the disease will be determined by several factors, including: the progression of the disease when discovered, the ability of the heart to pump efficiently and the age when diagnosed.

Preventing Heart Disease in General

Having a knowledge of the associated risk factors and taking measures to decrease the development of heart disease can be useful in the fight to prevent heart degeneration. Eliminating smoking, partaking in a good exercise routine, consuming less fats, controlling other pre-existing conditions like diabetes and maintaining an ideal body weight should help to lower the chance of acquiring the disease.