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Ischaemic heart disease

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Ischaemic heart disease is a disease characterized by reduced blood supply to the heart. It is the most common cause of death in most western countries.

Ischaemia means a "reduced blood supply". The coronary arteries supply blood to the heart muscle and no alternative blood supply exists, so a blockage in the coronary arteries reduces the supply of blood to heart muscle.

Most ischaemic heart disease is caused by atherosclerosis.

What is it?

  • Initially there is narrowing of coronary arteries causing angina.
  • The narrowing is mostly caused by fatty plaques lining the wall of the artery.
  • Sometimes a fatty plaque will rupture leading to a heart attack. (Heart attacks caused by simple narrowing are relatively uncommon).
  • A heart attack causes damage to heart muscle by cutting off its blood supply.

This can cause:

Prevention. Prevent or delay atherosclerosis.

  • Do not smoke.
  • Treat hypertension (high blood pressure)
  • Exercise regularly (Exercising the heart muscle strengthens it, like any other)
  • Avoid obesity: a large body puts unnecessary strain on the heart and increases serum cholesterol and triglycerides[?].
  • Avoid excess saturated fat in the diet. Some unsaturated fats may be beneficial in reducing the risk of heart disease when consumed in moderation. Dietary cholesterol is shown to have a modest effect on serum cholesterol.
  • Take cholesterol reducing drugs.

Treatment of a heart attack. Which of these options are required depends on the situation.

After a heart attack

  • Possible cardiac surgery.
  • Possibly the regular administration of anti-coagulants to prevent further arrhythmias
  • Possibly the regular administration of drugs to control heart rhythm.
  • Increase exercise within limits of safety (see prevention) to train the heart.

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