Ischemic Heart Disease

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shape-of-heart-organIschemic heart disease causes include a condition when the heart muscles get damaged due to a reduced blood supply to the heart. Ischemic heart disease occurs when your blood vessels become narrow or blocked, making it difficult for your heart to receive the oxygen and nutrients. Ischaemic heart disease occurs when the heart is not sufficiently supplied with blood causing damage to the heart muscle.

Ischemic cardiomyopathy or heart disease is a condition in which the heart can no longer pump enough blood to the rest of the body because of coronary artery disease. With heart failure blood moves through the heart and body less effectively and pressure in the heart increases. Ischemic heart disease comes from the heart muscle not getting an adequate supply of blood.

The symptoms of heart disease vary depending on the type of heart disease. One of the most common complications of ischemic heart disease is heart failure. The diagnosis of ischemic heart disease underlying particular symptoms depends largely on the nature of the symptoms.

Diagnosis of ischemic heart disease should be done by a qualified doctor as symptoms of ischemic heart disease can also be mistaken for other ailments. Ischemic heart disease is often directly related to coronary artery disease or atherosclerosis. To understand heart disease, you must first know how the heart works.

Untreated ischemic heart disease can result in heart attack or heart failure and is the leading cause of death in most Western countries. Ischemic heart disease is one of the top causes of death in the world today. The SCD population is dominated by coronary artery disease although some of the most disturbing instances of sudden cardiac death are not due to ischemic heart disease.

Ischemic heart disease is the leading cause of hospitalization and death in regards to heart disease in the world. In the United States, stroke is one of the leading causes of death. Ischemic heart disease is the leading cause of death among all age groups.

Men aged 45-64 years showed higher risk levels of IHD than women of the same age group. The risk of hospitalization is higher for men and women of 45-64 years and varies spatially. CHD risk was higher in men than in women but difference reduced in diabetic population.

Even though the average length of life 150 years ago was much less than it is now, there were millions of people who did live past 60 years of age. The smoking prevalence for men aged 45-64 years old is high in almost all regions and is either high or moderate in all regions for women of the same age. 35 people under 65 years of age die prematurely every day due to CVD.

heartbeat-isolated-on-white-backA high fat diet leads to a high amount of cholesterol in the blood. The shorter the amount of time between TIAs, the more likely you are to have a stroke.

The commonest symptom of IHD is chest pain but chest pain is common. Angina feels like pain in the chest and an uncomfortable tightness. The most common symptom is chest pain, known as angina pectoris. The pain from angina Pectoris is normally a pain over the center of the chest that can radiate down into the left arm, the back or into the jaw.

The pain may spread to the neck, jaw, back, shoulder, or arm. You may feel pain or discomfort in your chest, shoulders, arms, jaw, or back, especially when you exercise.

Reduction in coronary blood flow is related to progressive atherosclerosis with increasing occlusion of coronary arteries. In an attempt to cope with the build up of plaque, the arteries can expand to allow the blood flow to continue uninterrupted. One is the pathological buildup of abnormal plaque, or atheromas, in the arteries, plaque that gradually hardens through calcification.

The decreased blood flow is most often caused by narrowing of the coronary arteries, a condition called atherosclerosis. As the plaques build up, the arteries toughen and narrow from the debris buildup. Especially when the coronary arteries are closed by 50 percent or more, the stage is set for angina.

Heart-diseaseIntraoperative tachycardia was associated with a higher incidence of myocardial ischemia and infarction. Increases in peptic ulcer and in myocardial infarction are projected, and sometimes cited.

The gross morphologic appearance of a myocardial infarction can vary. Part A does not mention the possibility of an abnormal resting ECG showing cardiac ischemia. Mild cardiac depression by protamine is suggested but probably does not occur. A resting ECG performed while a person has angina will show myocardial ischemia about half the time.


Symptoms Of Unstable Angina

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You may experience symptoms of unstable angina after previously having symptoms of stable angina. Stable angina or typical angina pectoris is the most common form of angina. Unlike stable angina, unstable angina can occur without physical exertion and is not relieved by rest or medicine. Stable or silent angina is the most common form of angina in the elderly, and it occurs in an identifiable pattern. There are several different types of angina characterized by the timing and duration of symptoms. Stable angina is the most common form of angina and typically occurs with exertion and goes away with rest.

Chest-Pain-240x224Unstable angina is considered to be an acute coronary syndrome in which there is no release of the enzymes and biomarkers of myocardial necrosis. The biomarkers of necrosis are below the threshold of myocardial infarction. During unstable angina, no enzymes and bio markers of myocardial necrosis are released during unstable angina thereby making it to be an acute coronary syndrome. Several symptoms can help you discern the presence of unstable angina. There is insufficient population-based data describing the prevalence of acute myocardial infarction in sub-Saharan Africa. There is a form of angina called cardiac syndrome X.

Angina is due to a temporary reduction in the flow of blood to part of the heart muscle and does not damage the heart itself. A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. Because of the decreased flow of blood, there is not enough oxygen to the heart muscle resulting in chest pain. Angina can be caused by an insufficient supply of blood and oxygen to the heart muscle. The pain is a result of an area of muscle surrounding the heart that is not receiving enough oxygen. The pain is caused by inadequate blood supply to your heart, which leaves your heart deprived of oxygen.

A heart attack is a prolonged decrease in oxygen to the heart that results in permanent damage to the heart. Certain heart enzymes slowly leak out into your blood if your heart has been damaged by a heart attack. An attack of angina does not cause permanent damage to the heart muscle. When certain ECG findings are present, the risk of unstable angina progressing to a heart attack is significantly increased. Where a heart attack threatens to lead to permanent damage to your heart muscle an angina attack is not. People with untreated unstable angina are at high risk of a heart attack or death.

Chest pain is the most common symptom of angina and is often described as a feeling of tightness or as a heavy weight on the chest. The classic chest pain from angina feels like significant pressure, squeezing, or tightness in the center of your chest. The chest pain associated with angina pectoris is described as squeezing, pressing, burning, choking, or bursting felt along the sternum. The pain may feel like tightness, heavy pressure, squeezing, or crushing pain. Angina presents itself more as a chest discomfort, rather than frank pain, which is described as pressure, heaviness, tightness, squeezing, burning, or choking sensation. Because of the seriousness of the disorder, anytime someone has pain in the chest, it is ascribed to angina.

Red-Broken-HeartAtherosclerosis is the buildup of fatty material called plaque along the walls of the arteries. Angina occurs when one or more of the coronary arteries become narrowed or blocked. Resting angina may occur as a result of plaque buildup in the arteries causing a coronary spasm. The coronary arteries can become narrowed by a gradual build-up of fatty material within their walls. Variant angina occurs when there is a narrowing of the artery due to a spasm. The balloon is inflated and deflated, pressing against the plaque buildup on the walls of the coronary artery and increasing the diameter of the artery.

Angina is one of the symptoms of coronary artery disease. Recent research has linked periodontal disease with the risk of coronary artery disease and stroke. One of the most characteristic and troubling features of coronary disease is the sudden and unexpected onset of symptoms in clinically stable patients and sometimes in even previously healthy individuals. Patients with rapid progression of atherosclerotic disease at multiple sites experience unstable angina more frequently. The angina symptoms are a result of coronary heart disease. Because heart disease is often the cause of most forms of angina, you can reduce or prevent angina by working on reducing your heart disease risk factors.

Valentine’s day – a day to look after your and your loved one’s heart

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With Valentine’s Day approaching, it’s important that you look after things people love about you; your mind, your body and especially your heart.

Your heart keeps you alive by pumping blood around your body 24 hours a day for every day of your life so it makes sense to look after it. You can help reduce the risk of developing many types of heart disease by making some lifestyle changes. Here are a few tips:-

Eating an unhealthy diet high in fat can lead to hardening of the arteries and increase your risk of heart attacks. There are two types of fat-  saturated and unsaturated. Avoid foods containing high levels of saturated fat because they increase levels of bad cholesterol in your blood.

Foods high in saturated fat include:

  • meat pies
  • sausages and fatty cuts of meat
  • butter
  • ghee (a type of butter often used in Indian cooking)
  • lard
  • cream
  • hard cheese
  • cakes and biscuits
  • foods that contain coconut or palm oil

Eating a small amount of unsaturated fat will increase the level of good cholesterol and help reduce any blockage in your arteries. Foods high in unsaturated fat include:

  • oily fish
  • avocados
  • nuts and seeds
  • sunflower, rapeseed and olive oil


Smoking is a major risk factor for heart attacks because it causes atherosclerosis and raises blood pressure. Everytime you smoke, you are adding a layer of tar in the your heart arteries and progressively this will cause further narrowing of the heart arteries.


If you drink alcohol, do not exceed the recommended daily limits (no more than three to four units a day for men, and two to three units a day for women). A unit of alcohol is roughly half a pint of normal strength lager, a small glass of wine, or a single measure (25ml) of spirits.

Regularly exceeding the recommended alcohol limits will raise your blood pressure and cholesterol level, increasing your risk of another heart attack.

Avoid binge drinking (drinking more than three alcoholic drinks in one to two hours). Binge drinking can cause a sudden and large rise in your blood pressure, which could be potentially dangerous.

Make sure you are a healthy weight.
If you are overweight or obese, it is recommended you lose weight and then maintain a healthy weight using a combination of exercise and a calorie-controlled diet.

Regular physical activity
Physical activity is activity that requires you to use more energy than when you are resting.  It can include activities such as walking or gardening. The aim is to reach a stage where you are slightly out of breath

Healthy adults should do at least 150 minutes (two and-a-half hours) of moderate-intensity aerobic activity (such as cycling or fast walking) every week.

The level of activity should be strenuous enough to leave you slightly breathless.

Hopefully you already take good care of your heart and if you don’t, its never to late to start. With very good care, you may even be able to reverse some of the damage that has already been done. If you ever have any concerns about the health of your heart and want to discuss further, drop me an email.

best wishes for a very happy (and healthy) Valentine’s day!


The Last Heart Attack

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Welcome to my blog.

Some of you may know that I have a very illustrious namesake in the USA. This other Dr Sanjay Gupta is a neurosurgeon but has spent a large part of his career addressing  the issue of whether heart attacks can be prevented and even abolished. I was recently fortunate enough to watch his highly illuminating documentary.

We know that heart disease is caused by a furring up of the heart arteries. It is also well known that the process of furring up (atherosclerosis) starts decades before any of us have any symptoms of heart disease. By the time, we develop symptoms of chest discomfort or breathlessness on exertion or even at rest, it is often too late to reverse this process. Even though people have stents implanted or bypass operations, we know that these procedures simply provide symptom relief rather than a cure. Heart artery disease, once it has developed can not be cured and will undoubtedly contribute to a reduction in the sufferer’s lifespan.  Dr Gupta has found through years of interviewing some of the greatest minds in medicine that the only way to avoid having heart disease is by being aware of its ubiquity and by proactively finding out whether you have any signs of furring up in your arteries. Fortunately we now have the technology in the UK by which people can find out exactly what is happening inside their heart arteries and take steps to prevent or abort the process of atherosclerosis.  The technology is called CT coronary angiography and a few minutes through a scanner can give you a fairly accurate assessment of whether or not you are likely to develop a problem with your heart in the future. If the heart arteries look clean then you can relax and get on with your life. If the heart arteries show signs of some furring up, then by taking cholesterol lowering medicines (statins), getting regular exercise, losing weight and generally adopting a healthy lifestyle, it is possible to significantly slow down or even abort the process of heart artery disease.

You can watch Dr Gupta’s documentary here.

I would strongly urge you all to  be proactive about your health and particularly your heart. Please go and see your GP about whether CT coronary angiography is available in your area. If you have any questions or need advice, please don’t hesitate to contact me.