Ischemic heart disease (IHD), also known as coronary artery disease, is one of the most common forms of heart disease worldwide. It occurs when the heart muscle does not receive enough oxygen-rich blood due to narrowed or blocked coronary arteries. Understanding ischemic heart disease — its causes, symptoms, and treatments — is essential for maintaining heart health and preventing serious complications.

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What Is Ischemic Heart Disease?

Ischemic heart disease develops when plaque builds up in the coronary arteries, leading to reduced blood flow to the heart muscle. This condition can cause chest pain (angina), shortness of breath, heart attacks, and, in severe cases, heart failure.

Plaque buildup results from a process called atherosclerosis, where cholesterol, fat, and other substances accumulate inside artery walls. Over time, this narrows the arteries and limits blood supply.

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Causes and Risk Factors

Several factors contribute to the development of ischemic heart disease:

• High cholesterol: Excess LDL (“bad”) cholesterol promotes plaque formation.
• High blood pressure: Damages artery walls and accelerates atherosclerosis.
• Smoking: Harms blood vessels and reduces oxygen supply.
• Diabetes: Increases risk by damaging blood vessels.
• Obesity: Linked to high cholesterol, diabetes, and high blood pressure.
• Sedentary lifestyle: Lack of exercise worsens heart health.
• Unhealthy diet: High in saturated fats, trans fats, and sugars.
• Family history: Genetic predisposition can increase risk.
• Age and gender: Risk increases with age; men are at higher risk earlier, but women’s risk rises after menopause.
• Stress: Chronic stress negatively impacts heart health.

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Symptoms of Ischemic Heart Disease

Symptoms vary depending on severity but commonly include:

• Angina (chest pain): A pressing or squeezing sensation often triggered by physical exertion or stress.
• Shortness of breath: Especially during activity or at rest in advanced cases.
• Fatigue: Feeling unusually tired due to reduced heart efficiency.
• Heart attack: Sudden, severe chest pain accompanied by sweating, nausea, and shortness of breath.
• Palpitations: Awareness of irregular or fast heartbeat.

Some people may experience “silent” ischemia, where blood flow is reduced without obvious symptoms, making regular checkups vital.

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Diagnosis

Diagnosing ischemic heart disease involves:

• Medical history and physical exam
• Electrocardiogram (ECG/EKG): Detects abnormal heart rhythms and damage.
• Stress tests: Monitor heart function during exercise.
• Echocardiogram: Ultrasound imaging to assess heart function.
• Coronary angiography: Uses dye and X-rays to visualize artery blockages.
• Blood tests: Check cholesterol and cardiac markers.

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Treatment Options

Treatment aims to improve blood flow, reduce symptoms, and prevent complications:

1. Lifestyle Modifications

• Heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
• Regular exercise.
• Smoking cessation.
• Weight management.
• Stress reduction techniques.

2. Medications

• Antiplatelet agents: Prevent blood clots (e.g., aspirin).
• Statins: Lower cholesterol.
• Beta-blockers: Reduce heart workload and control blood pressure.
• Nitrates: Relieve chest pain.
• ACE inhibitors or ARBs: Help relax blood vessels.

3. Medical Procedures

• Angioplasty and stenting: Opens blocked arteries.
• Coronary artery bypass grafting (CABG): Surgery to bypass blocked arteries.

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Preventing Ischemic Heart Disease

Prevention focuses on controlling risk factors:

• Maintain a balanced, heart-healthy diet.
• Exercise regularly.
• Avoid tobacco use.
• Manage blood pressure, cholesterol, and diabetes.
• Maintain a healthy weight.
• Reduce stress.