Comprehensive Guide to Ischaemic Heart Disease
Explore a comprehensive guide to ischaemic heart disease, covering its causes, symptoms, risk factors, diagnosis, and treatment options. Learn how early detection and effective management can improve heart health and prevent complications.
Written by Dr Shreya Sarkar
Last updated on 3rd Jul, 2025
Ischaemic heart disease (IHD) or coronary artery disease is caused by reduced blood supply to the heart. This impairment is led majorly by atherosclerosis, which refers to deposits on the inner walls of the arteries, a condition associated with health risks such as heart attacks and heart failure, among others.
IHD remains one of the leading causes of death globally, claiming millions of lives each year. Therefore, increasing awareness, early detection of risk factors, and promoting prevention and management strategies are crucial to mitigating its impact.
Causes and Risk Factors
The primary underlying cause of IHD is coronary artery disease, where plaques of cholesterol, fats, or other substances accumulate in the coronary arteries. As a result of this, the blood vessels get clogged, and the oxygen supply to the heart is restricted, thereby straining the organ.
Some of the major risk factors include:
Age: Men aged over 45 years and women aged over 55 years are more vulnerable to suffering from a disease or becoming infected with a virus.
Genetics: A major risk factor is a family history of ischaemic heart disease, as lifestyle and living standards suggest vulnerability to IHD.
Lifestyle Factors: People who do not adhere to proper nutrition regimens, lead a sedentary lifestyle, indulge in smoking, and or chronic alcohol consumption, and individuals with kidney stones are also at high risk.
Medical Conditions: Elevated levels of BP, diabetes and high levels of cholesterol are important precursors, which considerately magnify arterial disease.
Pathophysiology of Ischaemic Heart Disease
The mechanism of IHD is based on reduced blood flow. This reduces the supply of oxygen to the heart muscle, mainly caused by the narrowing or blockage of the coronary arteries due to atherosclerosis (a situation where the inner layer of the coronary arteries is injured). Such factors as hypertension, high blood cholesterol, smoking and inflammation are the causes of this damage.
As the lining of the arteries (the endothelium) deteriorates, it triggers an inflammatory process. Cholesterol, particularly the low-density lipoprotein (LDL) particles, infiltrate into the lesions and are deposited in the intima of the artery. Over time, macrophages accumulate cholesterol, promoting the formation of fatty deposits and plaques. These plaques not only constrict the arterioles but also stiffen them in such a manner that it becomes very difficult for blood to flow.
In a more progressed state, the plaques themselves can rupture, releasing their contents into the bloodstream. This disruption sets off the coagulation process of the body and a thrombus (blood clot) forms. A thrombus can partially or completely block the coronary artery, leading to acute ischaemia.
Symptoms and Clinical Presentation
Some of the more common symptoms of IHD include:
Chest pain or discomfort (angina), often described as a squeezing or pressure-like sensation.
Shortness of breath, particularly during physical exertion.
Fatigue and weakness, especially in advanced stages of the disease.
Further, it is important to note that some individuals experience silent ischemia, where reduced blood flow to the heart occurs without noticeable symptoms. Atypical symptoms such as nausea, dizziness, or back pain can be more common in women and older adults.
Consult Top Doctors For Ischaemic Heart Disease
Diagnosis of Ischaemic Heart Disease
When it comes to the diagnosis of IHD, the following tools are often used:
Electrocardiogram (ECG): Detects electrical abnormalities in the heart caused by insufficient blood flow.
Stress Tests: Evaluate how the heart responds to physical activity or stress.
Coronary Angiography: Provides detailed images of blood flow through the coronary arteries, identifying blockages.
Imaging Techniques: Echocardiography, cardiac CT, or MRI offer additional insights into heart structure and function.
It is important to remember that early diagnosis is crucial to preventing disease progression and complications. Timely intervention can significantly improve outcomes and quality of life.
Treatment Options
In terms of treating IHD-related conditions, several medications and surgical interventions have been seen to be useful. Some of the medications used to treat IHD include:
Beta-Blockers: Reduce heart rate and oxygen demand
Nitrates: Relieve chest pain by dilating blood vessels
Statins: Lower cholesterol levels and stabilise plaques
Antiplatelet Agents: Prevent blood clots from forming in narrowed arteries
For the surgical treatment, the following options are generally considered:
Angioplasty and Stenting: A minimally invasive procedure used to open narrowed arteries and place a stent to keep them open.
Coronary Artery Bypass Grafting (CABG): A surgical procedure that creates new pathways for blood flow by bypassing blocked arteries.
Lifestyle Modifications and Prevention
Following a heart-healthy lifestyle is fundamental to preventing and managing IHD. This includes:
Eating a well-balanced diet full of vegetables, whole grains, fresh fruits and lean proteins.
Engaging in regular physical activity, such as 30 minutes of moderate exercise most days of the week.
Quitting smoking to improve overall cardiovascular health.
Further, controlling high cholesterol and blood pressure through lifestyle changes and medications is essential to reducing arterial damage and preventing IHD progression.
Complications of Untreated Ischaemic Heart Disease
Untreated ischaemic heart disease (IHD) can lead to severe, life-threatening complications. The prolonged restriction of blood flow to the heart muscle progressively damages its functionality, paving the way for acute and chronic conditions.
Myocardial Infarction (Heart Attack): Complete blockage of a coronary artery is a common consequence of untreated IHD, resulting in a heart attack. This occurs when a ruptured plaque triggers the formation of a blood clot, completely obstructing blood flow to a portion of the heart.
Heart Failure: When the heart’s pumping ability is diminished due to chronic ischemia, it may struggle to supply the body with adequate blood and oxygen. This condition, known as heart failure, leads to symptoms like fatigue, breathlessness, and fluid retention, significantly reducing the patient’s quality of life.
Arrhythmias: Disrupted blood flow can interfere with the heart’s electrical system, causing irregular heartbeats (arrhythmias). These can range from mild to severe, with some increasing the risk of stroke or sudden cardiac arrest.
Cardiac Arrest: Prolonged or severe ischemia can result in sudden cardiac arrest, where the heart abruptly stops beating. This is a medical emergency requiring immediate defibrillation and advanced care to prevent fatality.
Living with Ischaemic Heart Disease
Living with ischaemic heart disease (IHD) is a lifelong process in which a patient needs continuous medical attendance, changes in the usual life regimen, and psychological preparation. Managing this disease involves regularly watching for signs and following recommended therapies so as to avoid adverse effects and enhance general well-being.
Regular visits to healthcare providers are important. They have the opportunity to check up on the efficacy of the treatment, make changes to the drugs taken, and possible complications to be observed. In addition to regular mammograms and PSA tests, other diagnostic checks like blood pressure or lipid profile notify the doctor and patient about progression and or current heart states.
Therefore, it is important to embrace supportive systems in the care of IHD, as patients often experience significant emotional strain. An important benefit of support groups is the opportunity for patients to connect with others who have the same condition and share valuable insights. Psychotherapy is useful for stress, anxiety or depression, which is very rampant in patients with chronic diseases.
It is also important to adopt a heart-healthy lifestyle. This comprises using proper foods and eating balanced diets, exercising, for instance, depending on physical capabilities, and refraining from smoking and taking too much alcohol. The strategies outlined here are beneficial not only for physical health but also for psychological well-being.
Conclusion
Ischaemic heart disease is a leading cause of death worldwide, but it is largely preventable and manageable through early diagnosis, effective treatment, and lifestyle modifications.
Routine health screenings, combined with a commitment to heart-healthy habits, can significantly reduce the risk of IHD and improve outcomes for those living with the condition. Promoting awareness and prevention strategies is key to combating this global health challenge.
Consult Top Cardiologist
Consult Top Doctors For Ischaemic Heart Disease
Dr. Tripti Deb
Cardiologist
40 Years • MBBS, MD, DM, FACC, FESC
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
Dr. Sushith C
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Bhethala Sharan Prakash
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Zulkarnain
General Physician
2 Years • MBBS, PGDM, FFM
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Consult Top Cardiologist
Dr. Tripti Deb
Cardiologist
40 Years • MBBS, MD, DM, FACC, FESC
Hyderabad
Apollo Hospitals Jubilee Hills, Hyderabad
Dr. Sushith C
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Bhethala Sharan Prakash
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Zulkarnain
General Physician
2 Years • MBBS, PGDM, FFM
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
