What Is Ischaemic Heart Disease?

Ischaemic heart disease occurs due to an imbalance between the blood supply and the myocardial demand for blood. Myocardium gets oxygen and essential nutrients from the blood via two coronary arteries and their branches. If coronary blood flow to a part of the myocardium is reduced, ischaemic heart disease occurs. This can be due to a mechanical obstruction or a decrease in the flow of oxygenated blood to the myocardium.


Causes of mechanical obstruction

• Atheroma
• Thrombosis
• Embolus
• Coronary artery spasm
• Coronary arteritis
• Coronary ostial stenosis

Causes of decreased flow of oxygenated blood

• Carboxyhaemoglobinaemia
• Anaemia
• Hypotension

An elevated demand for oxygen and nutrients may occur because of increased activity (e.g. physical exertion, thyrotoxicosis) or enlargement (hypertrophy) of the heart. Hypertension or aortic stenosis results in myocardial hypertrophy.

The most common cause of ischaemic heart disease is coronary atherosclerosis, which is one of the obstructive coronary artery diseases (CAD). Additionally, changes in the tone of smooth muscle in the coronary artery wall can result in variable obstruction.

Coronary artery disease (CAD) is the main single cause of death in the world. Sudden cardiac death is a well-known feature of CAD. One-sixth of CAD attacks present with sudden death. It may be the first, last and only symptom.


Related Links:

Process of Atherosclerosis and Thrombosis
Complications of Atherosclerosis
Introduction: Risk Factors of Atherosclerosis
Non-modifiable Risk Factors of CAD
Modifiable Risk Factors of CAD
Other Risk Factors of CAD
Cardiovascular Disease (CVD) Prevention Policy