Ischaemic heart disease, also known as coronary artery disease, or coronary heart disease, is a leading cause of death in both men and women in many countries including Anguilla. It is largely preventable with proper treatment but, if untreated, it is associated with a higher risk of heart attack or heart failure.
What is ischaemic heart disease?
Ischaemic heart disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries, and inflammation, are usually to blame for ischaemic artery disease.
When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack. As ischaemic heart disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack.
What causes ischaemic heart disease?
Ischaemic heart disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including:
• Smoking
• High blood pressure
• High cholesterol
• Diabetes or insulin resistance
• Sedentary lifestyle
Once the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to accumulate at the site of injury in a process called atherosclerosis. If the surface of the plaque breaks or ruptures, blood cells called platelets will clump at the site to try to repair the artery. This clump can block the artery, leading to a heart attack.
What are some symptoms of ischaemic heart disease?
You might not have any symptoms especially in the early stages. Symptoms also vary from one individual to another. Some symptoms include the following:
• Chest pain (angina). You may feel pressure or tightness in your chest, as if someone were standing on your chest. This pain, referred to as angina, usually occurs on the middle or left side of the chest. Angina is generally triggered by physical or emotional stress.
The pain usually goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and felt in the neck, arm or back.
• Shortness of breath. You may develop shortness of breath or extreme fatigue with exertion.
• Heart attack. A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating.
Women are somewhat more likely than men are to experience less typical signs and symptoms of a heart attack, such as neck or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.
Prevention
The same lifestyle habits that can help treat ischaemic heart disease can also help prevent it from developing in the first place. Adopting a healthy lifestyle can help keep your arteries strong and clear of plaque. To improve your heart health, you can:
• Quit smoking
• Control conditions such as high blood pressure, high cholesterol and diabetes
• Stay physically active
• Eat a low-fat, low-salt diet that’s rich in fruits, vegetables and whole grains
• Maintain a healthy weight
• Reduce and manage stress
When to see your doctor?
If you suspect you are having a heart attack, immediately call 911. If you do not have access to emergency medical services, have someone drive you to the hospital. Drive yourself only as a last resort.
If you have risk factors for ischaemic heart artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, a strong family history of heart disease or obesity — talk to your doctor. He or she may want to test you for the condition, especially if you have signs or symptoms of narrowed arteries. It is important that patients with known coronary artery disease pay particularly close attention to their symptoms, and they should have a lower threshold to seek evaluation by their doctor or cardiologist.
Conclusion
Ischaemic heart disease can be prevented in some cases and in others it can be successfully treated. All indiviudals are encouraged to have a heart-healthy lifestyle, but it is even more important for those with or at risk of ischaemic heart disease. These lifestyle changes include eating a low-sodium and low-trans-fat diet, exercising regularly, avoiding tobacco smoking, and keeping cholesterol under control. Some patients might need to take medications or have some surgical procedures to help treat ischaemic heart disease. Although ischaemic heart disease is a leading cause of death, in many countries, it is also largely preventable with the right treatment.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
