Ischemic heart disease is the decrease of blood flow and oxygen to the heart, usually caused by narrowed or blocked arteries. The disruption in blood flow is known as coronary artery disease (CAD) and is currently the leading cause of death for both men and women in the United States.
One of the most common complications of ischemic heart disease is heart failure. Heart failure occurs when damage to the heart muscle causes it to become weak over time, resulting in inefficient pumping of blood to the rest of the body.
Ischemic heart disease can also lead to a heart attack, which is the result of complete blockage, and abnormal heart rhythms known as arrhythmias.
Symptoms of ischemic heart disease may include:
- Chest pressure or pain
- Jaw pain or abnormal sensations
- Arm pain or abnormal sensations
- Shortness of breath
In some cases, referred to as silent ischemia, there may be no symptoms and a heart attack may occur without warning. This is often the case in late-stage diabetics who have neurological problems.
Diagnosing Ischemic Heart Disease
Diagnosis involves a series of tests to examine the heart's structure and function, measure blood flow, and look for arterial blockages. Testing may include:
- An electrocardiogram (ECG)
- Blood tests (Troponin, CK-MB)
- Cardiac stress tests
- Coronary angiogram
Treating Ischemic Heart Disease
Treatment is aimed at improving blood flow to the heart to relieve symptoms and prolong the patient's life.
Treatment is multifaceted, with strategies that include:
- Stent placement
- Coronary artery bypass surgery
Lifestyle changes can help lower the risk of further damage to the arteries and heart. These include avoiding tobacco, exercising regularly, maintaining a healthy weight and diet, and taking cholesterol and high blood pressure medications as prescribed.
Surgical Approaches to Ischemic Heart Disease
Depending on the severity of the symptoms and disease, surgical procedures may include:
- Angioplasty/stent placement: A noninvasive procedure that uses a small balloon to help image the coronary arteries. If disease is found, and the physician finds that an intervention will improve flow in the artery, a metal stent is placed.
- Coronary artery bypass graft surgery (CABG): Surgery that restores blood flow to the heart by diverting the flow of blood around a section of blocked artery, using an artery (first choice) or vein taken from another area of the body.
- Hybrid approach: A minimally invasive surgical approach that avoids having to open the chest, and instead allows the surgeon to perform a CABG through a small incision between the ribs. There are multiple approaches to the minimally invasive procedure, with one of the most popular know as MIDCAB (minimally invasive direct coronary artery bypass). This approach can be combined with stents, which is known as hybrid revascularization.
For more information about treatment of ischemic heart disease at the Houston Methodist DeBakey Heart & Vascular Center, please call 713-DEBAKEY (332-2539) or complete our online contact us form.