Cardiac ischemia

Ischemic heart disease is a disease of the blood vessels of the heart with changes in the inner surface of the vessels, as well as the occurrence of deposits in the walls of the vessels. For this reason, there are disturbances in the blood supply to the heart muscle, which in the worst case leads to a heart attack.

Causes

In coronary heart disease, arteriosclerosis affects the blood vessels of the heart. From small fat deposits and sclerotic plaques to acute occlusion of the vessel in the context of an acute infarction - such is the spectrum of the described disease.

A key role in this process is played by LDL-cholesterol, low-density lipoprotein cholesterol, which is deposited in the walls of blood vessels and leads to an inflammatory reaction in them. Thus, lowering the level of cholesterol in the blood has a positive effect on the development of the disease.

Other risk factors are nicotine abuse, physical inactivity, high blood pressure, diabetes, and genetic predisposition.

Prevention

Light, but prolonged physical activity at least 3 times a week, complete cessation of smoking, maintenance of normal weight, “adjusted” blood pressure, optimal treatment of diabetes.

Symptoms

First under load, then at rest a feeling of pressure behind the sternum or in general in the chest area, often radiating to the arms, to the back of the head, to the teeth, to the upper abdomen. These complaints and sensations are often, especially in women, confused with pain in the stomach. In the case of myocardial infarction, these intense pains are prolonged, persistent and often unbearable. In at least a third of cases of myocardial infarction, it is not preceded by any complaints.

Diagnostics

For patients with no complaints, an individual picture of risk factors is compiled and, based on this, the risk of coronary heart disease is determined in percentage terms in the next 5 years.

For high-risk patients, bicycle ergometry (a type of stress ECG) is regularly performed to be able to assess cardiac function during exercise. We also use this examination method in cases of vague chest complaints. In typical angina pectoris, an examination with a cardiac catheter is indicated.

Treatment

In addition to the control of risk factors and appropriate targeted medical treatment, there are also other treatment options in the case of narrowing of the coronary vessels, such as expansion of the vessel with an elastic balloon with implantation of a shunt. We have been successfully using this method for 20 years.

If the narrowing of the vessel is in no way suitable for the method of expanding it with an elastic balloon, then perhaps the question arises of the need for heart surgery. Surgically, vasoconstriction sites are replaced with segments of the patient's own arteries or veins.