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Ischemic Heart disease: Causes, signs and treatment

Acute or chronic form of cardiac disability arising from myocardial ischemia- imbalance between myocardial supply and demand for oxygenated blood.  Ischemia comprises insufficiency of O2, nutrients and inadequate removal of metabolites. In 90% cases, cause is decrease blood flow due to obstructive atherosclerotic lesion, so alternatively called Coronary artery disease (CAD)
Ischemic heart disease is where atherosclosis affects the coronary arteries in the heart



Heart Disease


Heart disease, also known as cardiovascular disease, is a general term for a variety of conditions that affect the heart and blood vessels. It is a chronic disease that can lead to serious events including heart attack and death. Heart disease is one of the leading causes of death in Canada and worldwide. The most common form of heart disease is coronary artery disease (CAD) caused by atherosclerosis.




Atherosclerosis

Over time, plaque builds up on the inside wall of arteries. Plaque is made of several substances including cholesterol. This build up is called atherosclerosis or hardening of the arteries. It can start at an early age and is caused by a combination of genetic and lifestyle factors that are called risk factors. Atherosclerosis can cause a narrowing in the arteries to various parts of the body such that blood flow is slowed or blocked. Poor blood flow to the brain can cause a stroke. Poor blood flow to the arms or legs is called peripheral artery disease (PAD). Poor blood flow to the heart is called coronary artery disease (CAD) and can cause angina or a heart attack.

Angina

Plaque buildup in the coronary arteries to the heart causes poor blood flow and the heart may not receive all the oxygen that it needs. This usually occurs when the heart has to work harder such as while walking, climbing stairs, or feeling worried or upset. When the heart isn’t getting enough oxygen, it can cause pain or pressure in the middle of the chest that may spread to the arms, neck, or jaw. Sometimes there may be shortness of breath, sweating, or nausea. This pain is called angina and usually goes away within 2 to 20 minutes by resting or taking a medication called nitroglycerin. It does not cause any heart damage.

Unstable Angina

Sometimes, the plaque in the artery can crack open suddenly. The blood forms a clot over the cracked plaque but this clot causes a sudden narrowing of the artery. The chest pain or angina may now occur more frequently, with less exercise, or last longer than usual. This change in the pattern of angina is called unstable angina.

Heart Attack (myocardial infarction)
If the heart is starving for blood and not getting enough oxygen for more than 20 minutes, then a part of the heart muscle dies causing some permanent damage. This is called a heart attack or myocardial infarction (MI). Heart attacks are confirmed with blood tests and a test that shows the electrical activity of the heart called an electrocardiogram (ECG).

Ischemic Heart Disease
Ischemic heart disease is where atherosclosis affects the coronary arteries in the heart. If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina (an-JI-nuh or AN-juh-nuh) or a heart attack may occur.

Stroke Caused by Blocked Arteries

A frequent cause of stroke is plaque building up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, even for a few minutes, the lack of oxygen may cause damage, or even death of brain cells. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control.

Peripheral Arterial Disease (PAD)
Peripheral arterial disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. PAD usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your arms, kidneys, and stomach. Blocked blood flow to your legs can cause pain and numbness.

What Causes Ischemic Heart Disease?

All types of ischemic heart disease are caused by atherosclerosis. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include:
• Smoking
• High amounts of certain fats and cholesterol in the blood
• High blood pressure
• High amounts of sugar in the blood due to insulin resistance or diabetes

What Are the Signs and Symptoms of Ischemic Heart Disease?

Ischemic heart disease usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected.

How Is Ischemic Heart Disease Treated?

The most effective treatments for all ischemic heart diseases are quitting smoking, and medications to control high blood pressure and high cholesterol. Some people also need medications to prevent blood clots. The goals of treatment include:
• Relieving symptoms
• Reducing risk factors in an effort to slow or stop the buildup of plaque
• Lowering the risk of blood clots forming
• Widening or bypassing plaque-clogged arteries

Preventing atherosclerosis-related diseases
Following a healthy diet, being physically active, and maintaining a healthy weight and managing stress are also important to stopping or reducing the build-up of plaque and avoiding medical emergencies, complication and disability.
If you have severe atherosclerosis, your doctor may also recommend a medical procedure or surgery.

Living with Ischemic Heart Disease

Improved treatments have reduced the number of deaths from atherosclerosis related diseases. These treatments also have improved the quality of life for people who have these diseases.
If you have Ischemic Heart Disease take these smart steps to keep it under control and avoid serious problems, such as heart attack and stroke.

• Follow your treatment plan and take all of your medicines as your doctor prescribes
• Show up for your office visits or blood tests
• Let your doctor know if you have new or worsening symptoms
• Eat a heart healthy diet and keep your weight under control
• Keep a record of your blood pressure and cholesterol numbers
• Learn the warning signs of a heart attack and stroke




Reference 

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