Ischemic Heart Disease

March 23, 2021Articles2

Ischemic heart disease develops when cholestrol particles in the blood begin to accumulate on the walls of the arteries that supply blood to the heart. Eventually, deposits called plaques may form. These deposits narrow the arteries and eventually block the flow of blood. This decrease in blood flow reduces the amount of oxygen supplied to the heart muscle.A clot can sometimes obstruct the blood flow, causing serious health problems.

Coronary arteries form the network of blood vessels on the surface of the heart that feed it oxygen. If these arteries narrow, the heart may not receive enough oxygen rich blood,especially during physical activity.
Symptoms-

Causes –

Ischemia occurs when the blood flow through one or more of your coronary arteries is decreased. The low blood flow decreases the amount of oxygen your heart muscle receives.
IHD can develop slowly as arteries become blocked overtime. Or it can occur quickly when an artery become blocked suddenly.
Conditions that can cause ischemic heart disease include –
•Coronary artery disease (Atherosclerosis) –
Plaques made up mostly of cholestrol build up on your artery walls and restrict blood flow. Atherosclerosis is the most common cause of myocardial ischemia.
•Blood clot –
The plaques that develop in atherosclerosis can rupture, causing a blood clot. The clot might block an artery and lead to sudden, severe myocardial ischemia, resulting in a heart attack.Rarely, a blood clot might travel to the coronary artery from elsewhere in the body.
•Coronary artery spasm-
This temporary tightening of the muscles in the artery wall can briefly decrease or even prevent blood flow to part of the heart muscle. Generally, it is an uncommon cause of IHD.
Chest pain associated with IHD can be triggered by –
• Physical exertion
• Emotional stress
• Cold temperatures
• Coccaine use
• Eating a heavy or large meal
• Sexual intercourse

Types of angina pectoris or infarction-
In function of the symptoms,one can discern between different types of angina or infarction-
•Stable angina-
Chest pain is chronic and appears regularly, is always brought on by the same amount of exercise and does not change as the months pass by.Patients tend to be very familiar with the symptoms. While IHD always requires full attention, stable angina is chess serious and can be treated effectively with medicines.
• Acute coronary syndrome-
This corresponds to irregular episodes of chestpain, they appear suddenly, when resting the pain is much more intense or appears after increasingly less effort. This condition is more serious then stable angina and requires a hospital stay with intensive care.
Risk Factors-
A number of factors increase the risk of developing ischemic heart disease. Not all people with risk factors will get ischemic heart disease.Risk factors for IHD include-
• Diabetes
• Family history of heart disease
• High blood cholestrol
• High blood pressure
• High blood triglycerides
• Obesity
• Physical inactivity
• Smoking and other tobacco use
Complications –

• Heart Attack-
Heart attack occurs when the heart muscle does not have enough blood or oxygen, Such as when a blood clot develops from plaque in one of the coronary arteries.
The formation of a blood clot is called coronary thrombosis. This clot, if it is big enough, can stop the supply of blood to the heart.
Symptoms of a heart attack include –
• Chest discomfort
• Mild or crushing chest pain
• Shortness of breath
• A gray pallor in the face
• Coughing
• Dizziness
• General discomfort
• Nausea and vomitting
• Sweating
• Clammy skin
• Restlessness
• Panic
The first symptom is usually chest pain that spreads to the neck,jaw, ears, arms and wrists and possibly to the shoulder blades, back or abdomen.
Changing position, resting, or lyingdown is unlikely to bring relief. The pain is often constant but may come and go. It can last from a few minutes to several hours.
A heart attack is a medical emergency that can result in death or permanent heart damage. If a person is showing symptoms of a heart attack, it is vital to call the emergency services immediately.
• Irregular heart rhythm(arrhythmia) –
An abnormal heart rhythm can weaken your heart and may be life threatening.
• Heart failure –
Over time, repeated episodes of ischemia may lead to heart failure.
Diagnosis-
Your doctor will start by asking questions about your medical history and with a physical exam. After that, doctor might recommend-
• Electrocardiogram (ECG)
• Stress test
• Echocardiogram
• Stress echocardiogram
• Nuclear stress test
• Coronary angiography
• Cardiac CT scan
Treatment-
The goal of IHD treatment is to improve blood flow to the heart muscle. Depending on the severity of your condition, your doctor may recommend medications, surgery or both.
Medications –
• Aspirin –
A daily aspirin or other blood thinner can reduce risk of blood clots,which might help prevent blockage of coronary arteries.
• Nitrates –
These medications widen arteries, improving blood flow to and from your heart.
•Beta blockers –
These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure.
•Calcium channel blockers-
These medications relax and widen blood vessels, increasing blood flow in your heart.
•Cholestrol-lowering medications-
These medications decrease the primary material that deposits on the coronary arteries.
•Angiotensin-converting enzyme (ACE) inhibitors –
These medications help relax blood vessels and lower blood pressure.
• Ranolazine (Ranexa) –
This medication helps relax your coronary arteries to ease angina.
Procedures to improve blood flow-
• Angioplasty and stenting
• Coronary artery bypress surgery
• Enhanced external counterpulsation
Ayurvedic Perspective –
IHD may be considered as krimija hrida roga in Ayurveda. Ayurveda has designated heart as an origin of channel of rasa dhatu.This rasa dhatu is formed after digestion of food by gastric fire. Weak gastric fire,  consumption of improper diet, mental stress etc. lead to production of toxic, vitiated rasa dhatu.Toxins (ama) from rasa dhatu go into the heart and create blockages in channels. Such blockages result in IHD.
Procedures-
• Hrid Basti-

Beneficial Herbs-
• Garlic –

• Giloy –

• Gokshura-

• Arjuna –

• Pushkarmool-

Effective Medications-
• Prabhakar Vati
• Akik Pisti
• Jaharmohra Pisti
• Giloy sat
• Arjunarhishta
• Yogendra Ras
• Punarnava Mandur
Yoga and Pranayama –
• Tadasana –

• Vrikshasana –

• Utthita Hasta padasana-

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