Ischemic heart disease

Ischemic heart disease (IHD) is a chronic condition that arises from insufficient blood supply to the heart muscle (myocardium).

When blood flow decreases, the heart receives less oxygen and nutrients, leading to pain, rhythm disturbances, and reduced contractile ability. In advanced cases, a heart attack develops—necrosis of a portion of the heart muscle due to complete cessation of blood flow.

The primary cause of IHD is atherosclerosis of the coronary arteries, where cholesterol plaques form on the vessel walls, narrowing their lumen.

Risk Factors

The development of ischemic heart disease is facilitated by a combination of hereditary, metabolic, and behavioral factors. The most significant among them are:

• high blood pressure;
• high levels of “bad” cholesterol (LDL) and low levels of “good” cholesterol (HDL);
• smoking, which causes vasospasm and endothelial damage;
• diabetes and insulin resistance;
• overweight and obesity, especially abdominal;
• low physical activity;
• chronic stress, overwork, lack of sleep;
• hereditary predisposition to cardiovascular diseases;
• age and male gender (risk increases after 45 years for men and 55 for women).

Symptoms

The manifestations of IHD depend on the form of the disease and the degree of vascular damage. The most characteristic symptoms include:

1. angina pectoris—a squeezing or burning pain in the chest that occurs during physical exertion, stress, or after eating, radiating to the arm, shoulder, jaw, or back;
2. shortness of breath—a feeling of lack of air, especially during exertion or when lying down;
3. increased heart rate, irregular heartbeats;
4. increased fatigue, weakness, dizziness;
5. in severe cases—edema, nocturnal dyspnea, signs of heart failure.

Diagnosis

To confirm the diagnosis of ischemic heart disease, comprehensive examination methods are used:

• electrocardiogram (ECG)—records rhythm disturbances and ischemic changes;
• 24-hour ECG monitoring (Holter)—detects episodes of ischemia throughout the day;
• echocardiography (ECHO)—assesses the structure and function of the heart;
• stress tests (exercise testing, treadmill test)—determine the heart’s response to physical activity;
• coronary angiography—radiological examination showing the degree of narrowing of the coronary arteries;
• blood tests—to assess lipid profile, glucose levels, and inflammatory markers.

Treatment

Treatment tactics depend on the form and severity of IHD, but generally aim to improve blood supply to the myocardium, relieve pain, and prevent complications.

The main therapeutic approaches include:

• lifestyle changes—quitting smoking, dietary adjustments, weight reduction, blood pressure and sugar control;
• medication therapy—antiplatelets (aspirin, clopidogrel), statins, beta-blockers, nitrates, ACE inhibitors, or calcium antagonists;
• surgical methods—stenting (placing a metal frame in the vessel) or coronary artery bypass grafting (creating a detour for blood flow);
• physiotherapy and rehabilitation—gradual increase in physical activity, breathing exercises, emotional state control.

Prevention

Prevention of IHD involves eliminating risk factors and maintaining a healthy lifestyle. It is recommended to:

• regularly monitor cholesterol, sugar, and blood pressure levels;
• consume foods rich in omega-3 fatty acids, fiber, and antioxidants;
• reduce intake of trans fats, sugar, salt, and alcohol;
• engage in moderate physical activity for at least 30 minutes a day;
• maintain a healthy weight and avoid overeating;
• manage stress, practice relaxation techniques, and ensure adequate sleep;
• undergo preventive check-ups with a cardiologist, especially with hereditary predisposition.

Ischemic heart disease remains one of the leading causes of mortality worldwide. However, its development can be prevented: controlling risk factors, balanced nutrition, an active lifestyle, and timely treatment can significantly reduce the likelihood of a heart attack and maintain heart health for many years.