Ischemic Heart Disease (IHD)

ischemic heart disease (IHO) is a disease of the heart due to a deficiency of supply of blood, oxy­gen and nutrients to the heart. Ischemic heart disease occurs when there is imbal­ance between supply (of blood, oxygen, nutrients) and demand (increased demand, less supply).

Ischemic Heart Disease (IHD) Causes

• Atherosclerosis -is the commonest cause Coronary spasm
• Arterial thrombi
• Coronary emboli.

Causes other than coronary atherosclerotic heart disease:

• Luteic aortitis (Syphilitic)
• Anomalous origin of left anterior descending
• coronary artery from pulmonary artery
• Aortic stenosis with LVH
• Anaemia
• Kawasaki disease in children coronary artery affected)
• Aortic regurgitation (AR)
• Hypertrophic obstructive cardiomyopathy (HOCM).

Risk factors for Ischemic Heart Disease (IHD)

• Variable degrees of association and, in some studies, no associations have been found for diabetes and insulin resistance, dyslipidemia,hypertension,  and heart disease with VaD in population-based cohorts
• Age is nearly uniformly found to increase the risk of dementia after stroke
• High LDL (low density lipoprotein)
• Low HDL (high density lipoprotein)
• High TG and TC (triglycerides and total cholesterol)
• Stenoses within the coronary circulation most commonly occur in people who smoke
• Cigarette smoking
• Hypertension
• Diabetes mellitus
• Obesity.

Risk factors Role of Vascular Endothelium

• It maintains vascular tone
• It has anticoagulant surface
• It prevents inflammation
• Prevents atheroma formation .
• Prevents coronary artery disease
• The vascular endothelium is damaged by risk factors and atherosclerosis.
• plague fissuring, rupture of plaque, or haemorrhage into a plaque
• Collaterals do not develop in sudden occlusion of the coronary artery.
• Coronary blood supply is obstructed by atheroma, thrombus, thromboemboli, .
• When there is gradually progressive occlusion of the coronary arteries then collaterals develop which main­tain the perfusion of the heart.
• If the cross-sectional area of coronary artery is re­duced to 75⁰/0, then at the time of increased demand, the blood flow cannot increase appropriately It means there is significant coronary artey obstruction, and such patients are usually symptomatic.
• At 80⁰/0 reduction of the cross sectional areal the
• blood flow at rest is also compromised. Such
• patients are greatly handicapped, and are unable to carry out even routine activities without discomfort ..