IHD

IHD, or ischemic heart disease, is a term used to describe heart conditions caused by insufficient blood flow to the heart muscle. It most commonly arises from coronary artery disease due to atherosclerosis and includes chronic stable angina, acute coronary syndromes (unstable angina and myocardial infarction), and related conditions such as silent ischemia and chronic ischemic cardiomyopathy.

Pathophysiology and risk factors: Atherosclerotic plaque buildup narrows the coronary arteries, reducing oxygen delivery to myocardium. When blood supply cannot meet demand, chest pain and other symptoms may occur, and myocardial injury can ensue during acute events. Risk factors include modifiable factors—smoking, hypertension, high cholesterol, diabetes, obesity, physical inactivity, and unhealthy diet—and non-modifiable factors such as age, male sex, and family history.

Symptoms and diagnosis: Typical angina presents as pressure or squeezing chest pain that may radiate to the arm or jaw, often with shortness of breath and sweating. Myocardial infarction can have similar symptoms plus nausea. Diagnosis relies on clinical assessment, electrocardiography, and cardiac biomarkers (troponin); imaging such as echocardiography or nuclear/CT tests, and coronary angiography to map blockages.

Management: Acute myocardial infarction requires rapid reperfusion with percutaneous coronary intervention or thrombolysis, along with antiplatelet therapy and analgesia. Long-term care emphasizes lifestyle modification and guideline-directed medical therapy, including antiplatelets, statins, blood pressure and diabetes control, and heart rate and symptom management with beta-blockers, ACE inhibitors or ARBs, calcium channel blockers, or nitrates as appropriate. Revascularization by PCI or coronary artery bypass grafting may be indicated based on anatomy and symptoms.

Prognosis and epidemiology: Ischemic heart disease remains a leading cause of death and disability worldwide. Prognosis depends on disease extent, comorbidities, speed of treatment, and adherence to therapy; advances in prevention and treatment have reduced mortality and improved outcomes in many populations.