Description of the Disease
Ischemic heart disease (IHD), or coronary artery disease, is a condition in which the blood vessels supplying blood to the heart muscle narrow or become completely blocked by atherosclerotic plaques. As a result, the heart muscle (myocardium) cannot function effectively, and in the case of complete vessel occlusion by an atherosclerotic plaque or thrombus, a heart attack occurs.
Cause of the Disease
IHD is the leading cause of mortality among the adult populations of developed countries. Individuals at risk are typically men over 50 years old, those with excess body weight, engaging in harmful habits (smoking, overeating), and with elevated levels of blood pressure and cholesterol.
Heredity plays an important role: if direct relatives have experienced heart attacks or strokes, monitoring by a cardiologist is necessary after the age of 40.
Symptoms of the Disease
In most cases, a lack of oxygen in the heart muscle manifests with typical complaints of chest pain or discomfort between the shoulder blades, which may be accompanied by radiating pain in the left arm or jaw. Initially, the pain occurs with physical or emotional exertion and disappears with rest.
As the disease progresses and the degree of coronary artery narrowing increases, symptoms occur with minor exertion or even at rest and may be accompanied by feelings of fear, sweating, and shortness of breath. Such typical episodes are referred to as angina pectoris.
In some cases, there may be no pain, and the primary symptom becomes a sensation of breathlessness. It is important to consult a cardiologist and undergo examination at the onset of such sensations.
Diagnostics of the Disease
Upon experiencing the aforementioned complaints, it is essential to promptly consult a cardiologist. Discussion with the physician will help clarify the complaints, their onset conditions, and identify risk factors, some of which can be mitigated or reduced by medication or lifestyle changes.
One of the main highly specific diagnostic tests for ischemic heart disease is a stress test, which can be performed on a treadmill (treadmill test) or using a bicycle ergometer. During this test, an electrocardiogram (ECG) is recorded and/or an echocardiogram (EchoCG) is performed, allowing the assessment of how well the heart muscle copes with physical exertion and whether further diagnostic procedures are necessary.
If the stress test yields a positive result, the next step in diagnosing IHD is coronary angiography. This examination is performed in a hospital, and hospitalization lasts 1-2 days. The essence of coronary angiography is the injection of contrast medium into the heart's blood vessels to determine their patency and the degree of narrowing. Based on the results of coronary angiography, the next steps in treatment are determined.
Learn more about coronary angiographyTreatment of the Disease
The treatment of IHD can be approached through three main methods:
1. Conservative Therapy or Optimal Drug Treatment
A complex of recommendations for lifestyle changes and the intake of various groups of drugs aimed at reducing the progression of the disease and alleviating symptoms.
Conservative therapy always accompanies the other two treatment methods, which are surgical.
2. Coronary Artery Stenting
An intravascular procedure aimed at relieving narrowing of the coronary artery by inflating a special balloon at the site of the vessel's narrowing and placing a mesh-like metal stent coated with a special medication, reducing the likelihood of re-narrowing.
Coronary artery stenting is performed in the X-ray operating room, similar to coronary angiography, without requiring anesthesia, and is performed through a puncture in the radial or (rarely) femoral artery.
The postoperative period is short, and the patient is discharged within 1-2 days with recommendations for mandatory intake of special medications, which should be used for 6-12 months after stenting.
Learn more about coronary stenting3. Coronary Artery Bypass Grafting (CABG)
Surgical intervention aimed at creating bypasses around the narrowed segment of the coronary artery using the patient's own blood vessels: veins taken from the legs or arteries taken from the forearms or inner chest wall.
Coronary artery bypass grafting is the most commonly performed surgery worldwide, due to its high demand and good results. The surgery is performed using a heart-lung bypass machine or without it.
The postoperative period usually lasts 1 day in the intensive care unit and 5-7 days in the general ward. Patients are restricted from lifting heavy objects for 3 months, but otherwise, there are no significant limitations.
Learn more about coronary artery bypass graftingTreatment Prognosis
In the natural course of the disease, without treatment, ischemic heart disease (IHD) can quickly lead to disability and death for most patients. To date, the main cause of mortality in Russia is associated with IHD (27%).
Modern methods of cardiovascular system examination help diagnose IHD at early stages, painlessly, and quickly obtain information about existing risks and make the correct decision on the timing and method of further treatment.
The use of optimal drug therapy and lifestyle changes significantly reduces the risks of IHD progression and the development of complications (heart attack, heart failure, sudden death), while modern treatment methods restore patients to a full life, eliminate complaints, and prolong life.
In our clinic, you can undergo diagnostics and receive treatment for ischemic heart disease based on the results. Surgeries are performed regularly.