Ischaemic Heart Disease
Definition
Synonym : myocardial ischemia
A disease characterized by reduced blood supply to the heart muscle
Usually due to coronary artery disease (atherosclerosis of the coronary arteries)
Incidence
Its risk increases with
Age
Smoking
Hypercholesterolemia (high cholesterol levels)
Diabetes
Systemic hypertension
More common in men and those who have close relatives with ischaemic heart disease.
Symptoms
Stable ischaemic heart disease : angina pectoris, decreased exercise tolerance.
Unstable IHD : chest pain(angina) at rest, or rapidly worsening angina.
Angina pectoris : chest pain on exertion, in cold weather or emotional situations)
Myocardial infarction: severe chest pain unrelieved by rest associated with evidence of acute heart damage
Heart failure
Diagnosis
Electrocardiogram : maps the elcetrical activity of the heart
Blood tests (cardiac markers)
Cardiac stress testing
Coronary angiogram.
Echocardiogram : assesses the functioning of the heart
Treatment
Depending on the symptoms and risk, treatment may be
Medication
Percutaneous coronary intervention (angioplasty)
Coronary artery bypass surgery (CABG).
Cessation of smoking
Control of hyperlipidemia - statins
Control of Diabets mellitus - insulin, oral antidiabetics (metformin, gliclazide, thacitazones, sulphonyl ureas etc.
Control of systemic hypertension - ACE inhibitors (enalapril etc), betablockers (atenalol etc.), calcium channel blockers (amlodipine, nifidipine etc)
Antirouleaux formation drugs - clopidogrel, aspirin
Regular exercises
Relaxation techniques
.
