Ischemic Heart Disease
Disease Description
Ischemic heart disease (IHD) — also known as coronary artery disease (CAD) — is a condition in which the blood vessels supplying the heart muscle become narrowed or completely blocked by atherosclerotic plaques. As a result, the heart muscle (myocardium) cannot function effectively. When a coronary artery is completely occluded by a plaque or thrombus, a myocardial infarction (heart attack) develops.
Causes of the Disease
Ischemic heart disease is the leading cause of mortality among adults in developed countries. Individuals at highest risk include people (more often men) over the age of 50 with excess body weight, unhealthy lifestyle habits (such as smoking and overeating), high blood pressure, and elevated cholesterol levels.
Family history plays a significant role: if close relatives have experienced heart attacks or strokes, regular cardiology follow-up is recommended starting after the age of 40.
Symptoms
In most cases, reduced oxygen supply to the heart muscle manifests with classic symptoms — chest pain behind the breastbone or between the shoulder blades, which may radiate to the left arm or lower jaw. Early in the disease, this pain typically occurs during physical or emotional stress and resolves with rest.
As the disease progresses and coronary artery narrowing worsens, symptoms may appear with minimal exertion or even at rest and may be accompanied by anxiety, sweating, and shortness of breath. These characteristic episodes are known as angina pectoris.
In some cases, chest pain may be absent, and the main symptom may be a feeling of shortness of breath. At the first appearance of such symptoms, it is essential to consult a cardiologist and undergo evaluation.
Diagnosis
When these symptoms occur, prompt consultation with a cardiologist is crucial. A detailed discussion helps clarify symptoms, identify triggering factors, and assess cardiovascular risk factors — some of which can be modified with medication or lifestyle changes.
One of the most informative diagnostic tests for ischemic heart disease is an exercise stress test, performed on a treadmill or bicycle ergometer. During physical exertion, ECG recording and/or echocardiography are used to assess how well the heart muscle tolerates stress and whether further diagnostic testing is required.
If the stress test is positive, the next diagnostic step is coronary angiography. This examination is performed in a hospital setting and usually requires 1–2 days of hospitalization. Contrast material is injected into the coronary arteries to evaluate vessel patency and the degree of narrowing. Based on the results, a multidisciplinary team determines the optimal treatment strategy and whether surgical intervention is necessary.
Treatment
Treatment of ischemic heart disease includes three main approaches:
1. Conservative (Medical) Therapy
A comprehensive program of lifestyle modification and medication aimed at slowing disease progression and reducing symptoms.
Conservative therapy accompanies all other treatment methods, including surgical interventions.
2. Coronary Artery Stenting
A minimally invasive endovascular procedure designed to eliminate coronary artery narrowing. A special balloon is inflated at the site of stenosis, followed by placement of a metal mesh stent coated with medication to reduce the risk of re-narrowing.
Coronary stenting is performed in a catheterization laboratory, does not require general anesthesia, and is usually carried out through a puncture in the radial (wrist) or, less commonly, femoral artery.
Recovery is rapid, and patients are typically discharged within 1–2 days. Long-term use of antiplatelet medications for 6–12 months after stenting is mandatory.
3. Coronary Artery Bypass Grafting (CABG)
A surgical procedure that creates alternative pathways for blood flow around narrowed coronary arteries using the patient’s own veins or arteries.
CABG is one of the most frequently performed cardiac surgeries worldwide due to its proven effectiveness and long-term results. The operation may be performed with or without cardiopulmonary bypass.
Postoperative recovery usually includes 1 day in intensive care and 5–7 days in a general ward. Heavy lifting is restricted for approximately 3 months, but otherwise patients can return to normal activity.
Treatment Prognosis
Without treatment, the natural course of ischemic heart disease often leads to rapid disability and high mortality. Even today, ischemic heart disease remains a leading cause of death.
Modern cardiovascular diagnostic methods allow early detection of ischemic heart disease, rapid assessment of risks, and timely selection of the most appropriate treatment strategy.
Optimal medical therapy combined with lifestyle changes significantly reduces the risk of disease progression and complications such as myocardial infarction, heart failure, and sudden cardiac death. Contemporary interventional and surgical treatments restore quality of life, relieve symptoms, and prolong survival.
At our clinic, you can undergo comprehensive diagnostic evaluation and receive effective treatment for ischemic heart disease. Surgical procedures are performed on a regular basis.