Ischaemic Heart Disease

What is Ischaemic Heart Disease?

Ischaemia or ischaemic/ischemic heart disease is a condition in which the heart is starved of oxygen due to a reduced blood supply.

Most commonly, this is due to a build-up of plaque (fatty material plus cells) in the wall of one of the arteries supplying blood to the heart, known as the coronary arteries. As the plaque enlarges, it gradually obstructs the flow of blood, which deprives the heart of oxygen and nutrients.

The plaque can also rupture suddenly, that is it can tear away from the artery wall, which causes a clot to form very rapidly that completely obstruct the flow of blood. When that happens, the heart cells not getting any blood, stop functioning and die. This is a myocardial infarction (heart attack), which causes severe chest pain; an irregular heartbeat, which can be fatal; heart failure (an inability of the heart to pump sufficient blood to satisfy the body’s needs), or even death.

Is Ischaemic Heart Disease the same as Coronary Artery Disease?

No, it is not the same. Ischaemic Heart Disease can be a result of coronary artery disease but not in all cases. For example, a heart can become ischaemic if the demand for oxygen exceeds the supply that can be provided in the blood flowing through the coronary arteries.

One can have coronary artery disease without having ischaemic heart disease. For example, plaque may be present, which means the patient has coronary artery disease, but it is not large enough to limit blood flow sufficiently to cause the heart to become ischaemic.

What are the symptoms of ischaemic heart disease?

The most common symptoms of ischaemic heart disease include:

• Chest pain (angina)
• Shortness of breath
• Fatigue
• Sweating
• Palpitations

What is Silent Ischaemic Heart Disease?

Uncommonly, ischemic heart disease does not cause any symptoms even though the heart is starved for oxygen—this is known as silent ischemic heart disease.

How can ischaemic heart disease be diagnosed and is this the same for silent ischemic heart disease?

In order to diagnose either ischaemic heart disease or silent ischaemic heart disease, a doctor will ask questions about your personal and family medical history, order blood tests and conduct a physical examination. Further testing may be required which can include:

• Electrocardiogram (ECG)
• Echocardiogram
• Stress test
• Cardiac catheterization or angiogram
• Heart scan

Ask your doctor for a heart health check which looks at the key risk signs. Download our Heart Health Check Guide to take with you to your next doctor's appointment.

How is ischaemic heart disease treated?

Treatment for ischaemic heart disease may include:

• lifestyle changes – quitting smoking, losing weight, exercising, getting 7-9 hours sleep, eating a healthy diet etc.
• medications - aspirin and other anti-platelet agents (‘blood thinners’), statins, beta blockers, nitrates, ACE inhibitors, calcium channel blockers etc.
• other therapies to address risk factors and halt ischaemic heart disease progression – such as taking medications to control blood pressure, diabetes, and cholesterol
• angioplasty – where a small balloon is inserted into the artery and inflated to improve blood flow
• stenting – where a small wire mesh coil (stent) is inserted into the artery to improve blood flow
• coronary artery bypass surgery – where a blood vessel from another area of the body is used to create a graft that can bypass the narrowed artery to improve blood flow
• heart transplant, in select but severe cases