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The most frequent cause is atherosclerosis, characterised by the presence of plaques with a high cholesterol content (atheromas), but ischaemic heart disease can occur in any pathology or condition capable of totally or partially obstructing, chronically or acutely, the flow of blood within the coronary arteries, those that supply the myocardium.
Ischaemic heart disease presents different clinical manifestations such as stable and unstable angina pectoris and myocardial infarction.
The activity of the heart is characterised by a balance between the oxygen demand of the heart muscle and blood flow.
Indeed, the heart is an organ that uses large amounts of oxygen for its metabolism and, as we know, continuous cardiac activity is necessary for our survival.
In the presence of pathologies or conditions that alter this balance, an acute or chronic, permanent or transient reduction in the supply of oxygen (hypoxia or anoxia) and other nutrients contained in the blood can occur, which in turn can also irreversibly damage the heart muscle, reducing its functionality (heart failure).
Sudden obstruction of the coronary arteries can lead to myocardial infarction with a high risk of circulatory arrest and death of the patient if the coronary circulation is not quickly restored.
A distinction is made between causes of ischaemic heart disease and predisposing factors, better known as cardiovascular risk factors.
The cardiovascular risk factors of myocardial ischaemia are:
Prevention is the most important weapon against ischaemic heart disease.
It is based on a healthy lifestyle, which is the same as the one that must be followed by anyone suffering from heart problems.
First of all, it is necessary to avoid smoking and follow a diet low in fat and rich in fruit, vegetables and whole grains.
Occasions of psychophysical stress should be limited or minimised and regular physical activity, appropriate to the patient, should be preferred.
All ‘correctable’ cardiovascular risk factors should be corrected.
The diagnosis of ischaemic heart disease requires instrumental examinations that include:
The treatment of ischaemic heart disease is aimed at restoring direct blood flow to the heart muscle.
This can be achieved with specific drugs or with coronary revascularisation surgery.
Pharmacological treatment must be proposed by the cardiologist in collaboration with the treating physician and may include, depending on the patient’s risk profile or the severity of the clinical signs:
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