Heart disease is the leading cause of death in the United States. Ischemic heart disease is an umbrella term that refers to a variety of different diseases in which the coronary arteries are blocked. If left untreated, ischemia can lead to heart attacks and death.

Chronic ischemic heart disease is a family of diseases that are caused by the partial or complete blockage of one or more of your coronary arteries.

Heart disease is currently the leading cause of death in the United States, and knowing the signs and causes of ischemic heart disease can save your life.

Causes of Ischemic Heart Disease

The Heart

Chronic ischemic heart disease, or myocardial ischemia, is when blood flow to your heart is restricted, typically by a complete or partial blockage of your coronary arteries.

The reduced blood flow to the heart can cause muscle damage due to the lack of oxygen and nutrients. In instances where plaque ruptures and clots, ischemic heart disease can cause a heart attack.

Ischemic heart disease is also known as coronary artery disease or coronary heart disease. Several different diseases fall under the umbrella of chronic ischemic heart disease, though they all have the same cause of blocked arteries.

Ischemia can be deadly if left untreated – and sometimes it can be deadly even with medical intervention. Familiarizing yourself with the risks and symptoms can help you catch the disease early and improve your chances of recovery.

Risk Factors

Risk factors for this form of heart disease are almost identical to those of a heart attack. These similarities are unsurprising as both ischemia and heart attacks have similar causes.

The following are some of the risk factors for ischemia. If you know that you are at risk for a heart attack, you may also be at risk of ischemia.

  • Tobacco use
  • Diabetes
  • High blood pressure
  • High cholesterol
  • High triglyceride levels
  • Low physical activity

Smoking tobacco carries considerable risk on its own. However, some forms of smokeless tobacco also raise your blood pressure. Further, long-term exposure to second-hand smoke can have the same effect.

If you have diabetes or otherwise suffer from high blood sugar, high cholesterol, or high triglyceride levels, you are at an increased risk of heart disease. All of these conditions put additional strain on your heart and make it more likely to form a block.

High blood pressure puts strain on the coronary arteries, making them more susceptible to damage. Over time, this damage can increase your risk of ischemia or a heart attack.

Finally, regular physical activity helps improve your heart health and prevent blockages from forming. It can also help to lower your cholesterol and blood pressure, as well as help manage your diabetes.

In reality, any long-term stressors on your heart can cause it to be more susceptible to disease. This includes having a lot of stress in your life, such as from a job or your living situation.

Other risk factors can include a family history of heart disease, long-term stress, age, and previous heart attacks or other heart problems.

Stimulants, especially those found in illegal drugs, can also add strain to your heart and increase your risk of heart disease.

Prevention

The best ways to prevent or reduce your risk of disease are lifestyle changes. Improving your overall health and reducing stress can go a long way in preventing ischemia.

Some steps you can take to prevent ischemia include:

  • Improving your diet
  • Stopping tobacco use
  • Decreasing cholesterol
  • Treating high blood pressure
  • Increasing physical activity

Increasing fresh fruit and vegetable consumption can help prevent heart disease. Cutting out foods that have high cholesterol can also help improve your heart health and lower your cholesterol in general.

Quitting smoking is a great way to improve your overall health and decrease your risk for a number of different illnesses, including heart disease.

If you have high blood pressure and cholesterol, you should talk to your doctor about treatment options. Addressing diseases that put a strain on your heart is one of the best preventative measures you can take.

Increasing the amount of aerobic exercise (also known as cardio) can further help your cholesterol levels and blood pressure. It’s also been shown to improve your chances of surviving heart disease.

If you have a high risk of ischemia, you should go to the doctor regularly. Monitoring your heart health will make it easier to determine if something takes a turn for the worse.

Symptoms of Ischemic Heart Disease

Inside the heart

If you’re at risk for ischemia, you should familiarize yourself with the potential symptoms. Even if you don’t have ischemia, these symptoms are often signs of a larger health problem.

Ischemia doesn’t always present with symptoms. One form of it – silent ischemia – is almost completely symptomless. However, these are potential signs you may have ischemia:

  • Chest pain
  • Neck or jaw pain
  • Shoulder or arm pain
  • Fast or irregular heartbeat
  • Shortness of breath
  • Nausea
  • Sweating
  • Fatigue

Chest pain on the left side is the most common symptom, though women, older individuals, and people with diabetes may not experience chest pain and instead have other symptoms.

These symptoms are also associated with a heart attack. If you experience these symptoms suddenly or have a high risk of heart attacks or heart disease, seek out medical care immediately.

Not all forms of ischemia are associated with chest pain. If you have secondary symptoms but not chest pain, you should still seek out medical care.

Diagnosis

Doctors can provide a diagnosis after a series of tests. This may include:

  • Electrocardiogram (ECG)
  • Echocardiogram
  • Nuclear scan
  • Coronary angiography
  • Cardiac CT scan
  • Stress test

In an ECG, you have electrodes attached to your skin that measure the electrical activity of your heart.

An echocardiogram may look a lot like an ultrasound. In an echocardiogram, the doctor is able to look at your heart via sound waves, much like an ultrasound.

A nuclear scan involves a small amount of radioactive material injected into your blood. This material is then monitored as it flows through your body.

A coronary angiography is a different dye that’s injected into the blood vessels directly around or on your heart. Doctors then use an imaging device, such as an x-ray, to look at your blood vessels.

A cardiac CT scan can reveal coronary artery calcification, which is a form of ischemia.

Stress tests are when a doctor monitors your vitals while you exercise, typically on a treadmill or other stationary cardio exercise machine.

If your doctor suspects you have ischemia, you may have several tests done to monitor your heart health.

Once your doctor has a better idea of your current heart health, they can provide you with treatment options.

Treatment of Ischemic Heart Disease

The Doctor hold the heart

Doctors have a variety of options for treating ischemia, ranging from simple and non-invasive to open chest surgery. Doctors typically want to try less-invasive methods before considering surgery.

The first steps in treating ischemic heart disease are always lifestyle changes. If caught early enough, it may be sufficient in treating ischemic heart disease.

Lifestyle changes can include increased exercise, quitting tobacco, dietary changes, and reducing stress.

In some cases, doctors may prescribe medication to improve blood flow to your heart. Common medications include:

  • Aspirin
  • Nitrates
  • Beta-blockers
  • Calcium channel blockers
  • Cholesterol treatment
  • Angiotensin-converting enzyme inhibitors
  • Ranolazine

Low-dose aspirin has long been recommended as a way to increase blood flow and decrease the chances of blood clots. However, recent studies have called this conventional wisdom into question.

Nitrates help to open your arteries, improving blood flow.

Beta blockers relax your heart muscle, allowing blood to flow more easily.

Calcium channel blockers can help prevent calcium build-up and further increase the blood flow to your heart.

Cholesterol-lowering medications can also improve blood flow and overall heart health.

Angiotensin-converting enzyme inhibitors are most often used in patients with high blood pressure or diabetes in addition to ischemia.

Ranolazine is often used to help ease chest pain associated with ischemia.

While lifestyle changes and medications are the first steps in treating ischemia, sometimes they are not enough.

Options include:

  • Angioplasty and stenting
  • Coronary artery bypass surgery

Angioplasty and stenting is a minimally-invasive surgery that involves inserting a balloon into your blood vessels to open them up and then leaving behind a small piece of mesh, known as a stent. This procedure opens up your blood vessels and ensures that they stay open for a long time.

When other treatments have failed, or if there are further risk factors, doctors may recommend coronary artery bypass surgery. This is an open-chest procedure in which doctors will graft a blood vessel in place of a blocked artery.

Coronary artery bypass surgery is an invasive procedure that does not always eliminate that risks of ischemia.

If left untreated, ischemia can lead to a heart attack, arrhythmia, and heart failure. It’s better to have ischemia treated early and monitored under a doctor’s supervision than to risk these deadly complications.

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