What is Ischemic Heart Disease?

Ischemic heart disease is the medical term for a condition many of us know informally as coronary artery disease. This condition, though treatable, may be “silent” and cause no noticeable symptoms in some people who have it. In other cases, ischemic heart disease creates uncomfortable symptoms, which is actually a good thing since preventative treatment for the condition can begin. Even with treatment available, “silent” cases may not be noticed and can result in sudden death due to massive heart attack or fatal arrhythmias.

Essentially, you can define ischemic heart disease as deposits of fat or plaque that occur in the walls of the coronary arteries. Because these deposits reduce blood flow to the heart, several things can occur. First, the heart must pump harder to get its needed oxygen supply. This can result in enlargement of the heart muscle, which is very dangerous, especially if people are unaware of the problem. Enlarged heart and lowered oxygen supply can create sudden arrhythmias, and total occlusion of a coronary artery could lead to incidence of heart attack. Ischemic heart disease is one of the most likely things to create heart attack, and is responsible for the deaths of about half a million people a year in the US alone.

There are a number of risk factors for developing ischemic heart disease. These include family history, high cholesterol levels, being overweight, smoking, high blood pressure and pursuing diets that are high in fat (even if they don’t translate to weight gain). Stress is yet another cause that may create the condition, usually in conjunction with other symptoms. In early years of the condition, most people are unaware that they have it, unless they begin to develop chest pains during exercise.

Once ischemic heart disease is diagnosed, a treatment plan begins with medication and lifestyle changes. Lifestyle changes include eating a low fat diet, getting regular moderate exercise, losing weight and quitting smoking. This will only be part of the battle since it doesn’t necessarily reverse fatty deposits in the coronary arteries.

The goal then is to prevent ischemic heart disease from worsening, and this is done with a variety of medications.
These include giving nitrates for chest pain, beta-blockers to slow down resting heart rate, calcium channel drugs that may prevent arrhythmias, and blood thinning, or specifically platelet thinning medications that help to keep blood from clotting in narrower than normal arteries. Anti-cholesterol drugs called statins, which help lower blood cholesterol, may also be used to reduce greater plaque build up in the coronary arteries. Due to the potential for sudden life-threatening arrhythmias, the condition may additionally be treated with implantation of a defibrillator, which helps to control abnormally fast heart rhythms.

If physicians deem that ischemic heart disease is severe enough, they may opt for several surgical or non-invasive procedures to address the condition. People may have treatments like balloon angioplasty, which can help to widen the coronary arteries if they are not getting adequate blood supply to the heart. Alternately, coronary bypass surgery can help improve the heart’s condition. If heart enlargement is severe and danger of fatal myocardial infarction or life-threatening arrhythmias remains uncontrolled with an implanted defibrillator, then heart transplant may be required.