Home > Ischaemic heart disease

Ischaemia means a "reduced blood supply". The coronary arteries supply blood to the heart muscle and no alternative blood supply exists, so a blockage in the coronary arteries reduces the supply of blood to heart muscle.

Most ischaemic heart disease is caused by atherosclerosis, even when the artery lumens appear normal by angiography.

1 What is it?

• Initially there is sudden severe narrowing or closure of either the large coronary arteries and/or of coronary artery end branches by debris showering downstream in the flowing blood. It is usually felt as angina, especially if a large area is affected.
• The narrowing or closure is predominantly caused by the covering of atheromatous plaques within the wall of the artery rupturing, in turn leading to a heart attack (Heart attacks caused by just artery narrowing are rare).
• A heart attack causes damage to heart muscle by cutting off its blood supply.

This can cause:

• Temporary damage and pain ( ischaemia)
• Most death is due to arrhythmias, usually tachyarrhythmias
• Loss of muscle activity (acute heart failure)
• Permanent heart muscle damage, heart muscle does not grow back (acute myocardial infarction /infarct)
• Long term loss of heart muscle activity (chronic heart failure)
• Cardiac arrhythmias: irregular heartbeat which can be fatal.
• Other structural damage to the heart including damaged heart valves, actual perforation of the heart and a thin walled fibrous floppy heart.

2 Prevention

Prevent or delay atherosclerosis.

• Do not smoke.
• prevent/treat hypertensionIn medicine, hypertension refers to the problem of abnormally high blood pressure. There are three main types of hypertension, namely: # arterial hypertension with an elevated blood pressure in the systemic circulation # pregnancy-induced hypertension is (high blood pressure)
• Exercise regularly (Exercising the heart muscle strengthens it, like any other)
• Avoid obesityObesity is a condition in which the natural energy reserve of a mammal (such as a human), which is stored in fat, is expanded far beyond usual levels to the point where it causes health stress. Obesity in wild animals is relatively rare, but it is common: increasing body fat stores, especially intra- abdominal fat, increases serum cholesterolCholesterol is a steroid lipid, found in the cell membranes of all body tissues, and transported in the blood plasma, of all animals. Most cholesterol is produced internally, not dietary in origin. It is present in higher concentrations in tissues which e, triglycerideTriglycerides or triacylglycerols are natural fats and oils, composed of glycerin (chemically, "glycerol") and fatty acid chains. Chemical structure The fatty acids are linked to the glycerol so as to form 3 ester functional groups: : CH COOR CH COOR' CHs, insulincarbon; green: oxygen; blue: nitrogen; pink: sulphur. The blue/purple ribbons denote the skeleton [-N-C-C-]n in the protein's amino acid sequence H-[-NH-CHR-CO-]n-OH where R is the part protruding from the skeleton in each amino acid. Insulin ( Latin insu requirements and promotes Diabetes Mellitus plus chronicly increases heart muscle workload.
• Avoid excess process modified saturated fats, often called transfats in the diet. Some mono-unsaturated fats are probably beneficial in reducing the risk of heart disease when consumed in moderation. Dietary cholesterol intake is known to have only limited effect on serum cholesterol.
• Take LDLipoprotein cholesterol reducing and HDLipoprotein raising drugs and verfiy both LDLipoprotein particle counts and quantitative large HDLipoprotein response to treatment.