What Is Ischemic Heart Disease?

25 January, 2021
Ischemic cardiopathy is a serious disease which consists of insufficient blood flow to the heart. In this article, we'll tell you more about it.

Coronary heart disease is known as ischemic heart disease. As its name indicates, the underlying process that causes the problem is ischemia, or lack of blood flow to the heart.

The most common cause by far is arteriosclerosis. When small and large plaques of fat form on the walls of the arteries that supply blood to the heart, then the flow to the heart decreases. As a result, the heart lacks the oxygen it needs to work.

In ischemic heart disease, the arteries that become clogged or decrease their flow are the coronary arteries. These vessels are small tubes that carry blood to the heart muscle, known as the myocardium.

Atherosclerosis doesn’t happen overnight; on the contrary, it’s a slow process that takes years to form. During this period, traces of fat, cholesterol, collagen and some inflammation cells such as lymphocytes slowly accumulate on the walls of the arteries.

In developed countries, ischemic heart disease is the leading cause of death. Specialists estimate that out of every 10 people with this pathology, at least 5 have serious episodes, such as angina pectoris or acute myocardial infarction.

Risk factors for ischemic heart disease

Although the ultimate cause of ischemic heart disease is arteriosclerosis, we know that there are factors that predispose to it. Certain natural conditions or life habits make the disease likely. A publication in the Electronic Medical Journal points out the following risk factors:

  • Age: The older you get, the more frequent ischemic heart disease becomes.
  • Being male: It’s more frequent among men than among women. However, the latter are at increased risk when entering menopause.
  • High cholesterol: If a person has high and constant cholesterol levels, they’re at risk as fat is the main component of arteriosclerosis plaques.
  • Tobacco: Smokers have a much higher risk of developing ischemic heart disease than non-smokers. The association between this bad habit and heart problems has been known for many years.
  • Chronic diseases: There are two pathologies that have myocardial infarction as a serious complication are diabetes mellitus and arterial hypertension. Patients with these diseases must follow a strict medical control in order not to culminate in an episode that can be fatal.
  • Sedentarism: The lack of physical activity is behind multiple unhealthy conditions for the human being. In more developed societies, the lack of movement in the form of exercise is more notorious, and, therefore, the symptoms associated with cardiac ischemia are more frequent.
  • Obesity: Hand in hand with many other risk factors, and also in relation to developed societies, obesity is a serious risk factor. High weight generates high blood pressure, diabetes, metabolic dysfunctions that alter cholesterol and, of course, arteriosclerosis.
Visual representation of atherosclerosis.

Also read: Cholesterol in Seafood: Does it Affect Your Lipid Profile?

Types of ischemic cardiopathy

Ischemic cardiopathy is silent and develops slowly and progressively until it manifests itself externally. It can manifest in three different ways we will now detail.

1. Stable angina pectoris

Stable angina pectoris is a pain in the heart area that becomes recurrent, that is, it repeats with similar intensities. The episode of pain doesn’t last long – 10 minutes on average – although for the patient it seems like an eternity. As detailed by Medline Plus, it’s an oppressive pain in the chest, as if someone else were squeezing the chest very hard.

2. Unstable angor pectoris

Unstable angor pectoris is angina pectoris that has evolved and become unpredictable. It’s no longer always the same and repetitive chest pain, but appears at any time, even when the person is just resting.

According to a study published by the Cuban Journal of Biomedical Research, the pain is more intense and radiates from the chest to the left arm and neck. It’s the sign that warns the person that they may experience a heart attack. When doctors try to diagnose it, they may not find signs in the electrocardiogram.

3. Acute myocardial infarction

Lastly, the most serious and potentially fatal episode in the context of ischemic heart disease is acute myocardial infarction. In this case, the pain in the chest is intense, to the point of being unbearable.

It’s prolonged and doesn’t subside, sometimes it goes on for as long as 20 or 30 minutes. Other symptoms accompany it, such as shortness of breath, sweating, vomiting and anxiety. It requires immediate medical attention.

A man in pain due to ischemic heart disease.
Chest pain is the characteristic symptom of acute myocardial infarction.

Also read: Learn All about Chest Pain

Treating ischemic heart disease

The treatment for ischemic cardiopathy has three alternatives. These will depend on the clinical picture, on how advanced the obstruction of the coronary arteries is, and on the urgency. These alternatives are:

  • Medication: The doctor will instruct a person with coronary artery obstruction to use various drugs, including antiplatelet drugs.
  • Angioplasty: This is a procedure for relatively stable patients that consists of entering the person’s circulatory system, through a catheterization, and repairing the obstructions found in the coronary arteries.
  • Surgery: In heart attacks, if the medicines administered in the first instance don’t work, surgical treatment is performed. There are various surgical techniques for restoring blood flow to the heart muscle, including bypass surgery.

You should always visit your doctor to carry out the corresponding studies before the first symptoms of pain in the chest. Major complications can be avoided with early detection of the disease.

  • Achiong Alemañy, Fernando, Mercy Achiong Alemañy, and Fernando Achiong Estupiñán. Prevención de la cardiopatía isquémica, un desafío de la atención primaria de salud. Revista Médica Electrónica 37.2 (2015): 141-153.
  • Sanchez-Garcia, M. Esther, et al. Evaluación cuantitativa de los cambios microvasculares capilaroscópicos en pacientes con cardiopatía isquémica establecida. Medicina Clínica 150.4 (2018): 131-137.
  • Sellén Crombet, Joaquín, Sellén Sánchen, Elizabeth, Barroso Pacheco, Lourdes, & Sellén Sánchez, Sybert. (2010). Diagnóstico y tratamiento de la angina inestable aguda e infarto miocárdico sin elevación del segmento ST. Revista Cubana de Investigaciones Biomédicas, 29(2), 274-293. Recuperado en 17 de junio de 2020, de http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03002010000200010&lng=es&tlng=es.
  • Angina estable. Medline Plus. https://medlineplus.gov/spanish/ency/article/000198.htm#:~:text=Es%20una%20molestia%20o%20dolor,vasos%20sangu%C3%ADneos%20en%20el%20coraz%C3%B3n.