ISCHEMIC HEART DISEASE
Ischemic heart disease is a sickness in which the fatty plaque deposits narrow artery walls leading to the heart reducing blood flow. When a clogged artery totally blocks blood flow, a heart attack occurs. Ischemic heart disease is the highest cause of death in Western countries but reported to be very few in sub-Saharan Africa. There are suggestions that the incidence of Ischemic heart disease is rising in Nigeria as a result of many factors.
Ischemic Heart disease is still relatively uncommon in Nigeria and does not add significantly to morbidity and mortality from cardiovascular diseases in Nigeria. There is however considerable evidence that the incidence of IHD has increased over the past four decades. The conditions responsible for this trend include, increasing prevalence of IHD risk factors, urbanization and adoption of western diet and way of life.
Ischemic Heart Symptoms
Ischemic heart disease (IHD) symptoms can include gentle to severe chest pain (angina) or no pain of any form. That’s why regular checkups are essential. Ischemic heart disease symptoms include:
• Pain in the chest or upper part of the body that may last for hours or days
• Pain in the left shoulder or within the shoulder blades
• Shortness of breath
• A cold sweat
• Dizziness or lightheadedness
Ischemic Heart Disease Diagnosis
The use of advanced technology to diagnose, treat and carefully observe ischemic heart disease (IHD).
Blood test: Blood screening check the levels of certain fats, cholesterol, sugar and protein in the blood that could depict heart conditions.
Cardiac catheterization: A long, slim flexible tube is threaded through a blood vessel in the arm or groin and to the heart. difference material is injected through the tube and a type of X-ray video is taken to show how the heart functions and to find heart blockages.
Electrocardiogram (EKG): This test measures the electrical activities of the heart and can aid verify if parts of the heart are enlarged, stressed or damaged. The heart’s electrical currents are captured by 12 to 15 electrodes that are connected to the arms, legs and chest via sticky tape.
Holter monitor: This portable EKG device continuously reports the heart’s rhythms and is worn for 24 to 48 hours during regular activity.
Radionuclide imaging (thallium stress test):This non-invasive technique can discover if there is severe heart damage. A radioactive isotope is injected into a vein and a unique camera or scanner records how it travels through the heart. Any heart condition can be plotted, locating the damaged area of the heart. This measure can be done with an electrocardiogram, during both rests an exercise.
Stress testing: This test is performed during exercise. If a person can't exercise, medicine is administered to increase heart rate. Used together with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure. Exercise helps the heart work hard and beat fast when heart tests are conducted.
Ischemic Heart Disease Causes
Factors leading to Ischemic heart disease include:
• High blood pressure
• High cholesterol
• Tobacco use
Risk factors that may contribute to ischemic heart disease include:
Age: Men over 50 with a family history of heart disease and women after menopause ends are mostly at risk for ischemic heart disease.
Family history: Persons with a family history of heart disease are more likely to get ischemic heart disease.
Heart attack: A previous heart attack increases the chances of developing ischemic heart disease.
While risk factors like heredity cannot be controlled, there are measures you can apply to prevent ischemic heart disease:
Practice good heart health: Check what you eat, exercise and limit smoking.
Take your medications as prescribed: If you have high blood pressure, high levels of cholesterol or diabetes, be sure to take your prescribed medications as directed.
Ischemic Heart Disease Prognosis
Prognosis for ischemic heart disease depends entirely upon how early the disease and its underlying causes are diagnosed and treated. A good prognosis can be expected if the heart has not been seriously damaged and if the patient maintains a healthy lifestyle, takes prescribed medications as instructed and seeks regular follow-up care.
Treatment and Recovery
Treatment of ischemic heart disease aims at reducing symptoms and treating the underlying causes of the condition. An individualized treatment schedule can include medications, lifestyle changes, medical procedures or surgery. Depending on age and how intense the condition is, treatment can include:
A few lifestyle changes can assist with quality of life and improve symptoms. Your doctor can tailor a heart-healthy diet and daily exercise program for you to follow to lower your risk of a heart attack.
Medications can be prescribed to enhance cardiac function; treat symptoms like heart rate, high blood pressure and diabetes; and stop complications. Medications can include:
• ACE inhibitors, calcium-channel blockers, beta blockers or diuretics to reduce blood pressure.
• Aspirin to stop blood clots.
• tPA or tenecteplase to dissolve blood clots.
• Statins to regulate or reduce cholesterol and lower the risk of stroke or another heart attack.
Surgical treatment depends upon the intensity of your ischemic heart disease. Procedures can include:
• Angioplasty and stenting: For this procedure, a small balloon is inserted to widen narrowed or blocked blood vessels of the heart and increase blood flow. A vascular surgeon may insert a stent, a small metal mesh tube, to support artery walls and keep blood vessels wide open.
• Atherectomy: This procedure, just like angioplasty, removes plaque that blocks arteries in order to enhance blood flow to the heart. During this procedure, a thin tube (catheter) is inserted into a vein or artery through a small incision in the arm, neck or groin. The catheter is cautiously threaded into the blocked artery. The tip of the catheter removes the plaque and absorbs it. When the catheter is removed, the plaque follows it.
• Coronary artery bypass grafting (CABG): This surgical process creates a bypass around the narrowed coronary arteries by arteries or veins taken from other parts of the body to enhance blood flow prevent chest pain and stop a heart attack.
• Laser angioplasty: A laser dissolves a blood clot that is preventing the blood flow of an artery.
• Percutaneous coronary intervention (PCI): This procedure, also known as coronary angioplasty, can open a blocked artery, enhance blood flow and diminish chest pain. A stent, which is a small mesh tube, may be inserted to keep the artery open.
Recovery After Surgery
Based upon your condition, you may have your surgery as an out-patient, or you could stay in the hospital up to five days. It can be for few weeks or months until you feel able to fully resume your usual activities. Your doctor will provide full information about your recovery time and when you can become completely active again.
Follow-up Care After Surgery
Before you leave the hospital, your doctor will discuss your follow-up plan, which will likely include checkups at one month, six months, 12 months and annually thereafter. To lower the risk of complications, it is essential that you follow the health plan created for you after your surgery, which can include:
• Your diet should be low in fat, cholesterol and salt
• Exercise daily
• Stop smoking
• Reduce stress
• Take any prescribed high blood pressure or diabetes medications as instructed
Ischemic heart disease complications may include:
Heart attack or stroke: If you have ischemic heart disease, you may be at greater risk for developing a blood clot which may lead to a heart attack or stroke.
Other heart problems: Ischemic heart disease can result to other heart problems, including abnormal heart rhythm and heart failure.
Frequent hospitalizations: People with ischemic heart disease are always in the hospital.
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