Ischaemic heart disease
Ischaemic heart disease is the most common cause of death in most western countries. It also causes causing a reduction in the sufferer's quality of life.
Ischaemia means a "reduced blood supply". The coronary arteries supply blood to the heart muscle and no alternative blood supply exists, so a blockage in the coronary arteries reduces the supply of blood to heart muscle.
Most ischaemic heart disease is caused by atherosclerosis. (See heart.)
What is it?
- Initially there is narrowing of coronary arteries causing angina.
- The narrowing is mostly caused by fatty plaques lining the wall of the artery.
- Sometimes a fatty plaque will rupture leading to a heart attack. ( Heart attacks caused by simple narrowing are relatively uncommon).
- A heart attack causes damage to heart muscle by cutting off its blood supply.
This can cause:
- Temporary damage and pain (ischaemia)
- Loss of muscle activity (acute heart failure)
- Permanent heart muscle damage (acute myocardial infarction /infarct)
- Long term loss of heart muscle activity (chronic heart failure)
- Cardiac arrhythmias: irregular heartbeat which can be fatal.
- Other structural damage to the heart including damaged heart valves, actual perforation of the heart and a thin walled fibrous floppy heart.
Prevention. Prevent or delay atherosclerosis.
- Do not smoke.
- Treat hypertension (high blood pressure)
- Exersize regularly (Exercising the heart muscle strengthens it, like any other)
- Avoid obesity (a large body puts unnecessary strain on the heart)
- Avoid excess fatty foods and sugary foods. Expecially cholesterol containing foods.
- Take cholesterol reducing drugs.
Treatment of a heart attack. Which of these options are required depends on the situation.
- Specialised coronary care (the sooner the better).
- Cardiopulmonary resuscitation (heart massage).
- A defibrillator can revert cardiac arrhythmias.
- A cardiac pacemaker can prevent cardiac arrhythmias.
- Drugs such as adrenaline can increase heart rate.
- Thrombolytic agents can clear away the causative blood clot.
- Anticoagulation can prevent additional blood clots.
- Inotrophic drugs will raise blood pressure.
- Unblock arteries with surgery or angioplasty ("balloon angioplasty")
After a heart attack
- Possible cardiac surgery.
- Possibly the regular administation of anti-coagulants to prevent further arrhythmias
- Possibly the regular administation of drugs to control heart rhythm.
- Increase exersize within limits of safety (see prevention) to train the heart.