Signs and Symptoms
In the initial stages of the disease it is unlikely for any symptoms to manifest.
The primary symptoms that will be present after the disease has progressed will include angina pectoris and heart failure.
Angina Pectoris is chest pain that may occur in times of emotional distress, in cold weather conditions and during physical activity. It may radiate from the chest area to the jaw, shoulder blades, neck and left arm. There are cases of ischaemia that will not exhibit any form of angina attacks and in such cases it is defined as silent ischaemia.
Heart failure may result from ischaemic heart disease. This may cause shortness of breath or difficulty breathing which worsens during physical activity or when lying flat, pronounced coughing, decreased ability to perform normal activities and or swelling of the ankles.
Though the specific cause of Ischaemic heart disease is unknown there are some factors that tend to increase the likelihood of developing the disease.
Having a family history of certain other conditions may increase overall risk. These include diabetes, coronary artery disease, atherosclerosis and hypertension.
- Lacking proper nutrition, in particular consuming foods that are high in fat.
- Being a smoker especially one who smokes at least one pack of cigarettes per day.
- Having suffered from a heart attack of stroke at least once.
- Being significantly overweight or obese.
- Leading a very stressful lifestyle.
- Having elevated cholesterol levels
- Suffering from uncontrolled high blood pressure or hypertension
- Being a diabetic
- Leading a sedentary lifestyle or lacking sufficient levels of physical activity to maintain health.
Diagnosing and Treating the Disease
Once angina is suspected after experiencing chest pain, tests are performed to confirm the likelihood of an angina attack. The chest pains will first be determined to have materialized as a result of physical activity that is alleviated by rest or from being exposed to cold conditions or because of lying flat. An electrocardiogram or ECG may be performed to observe the changes that occur during an attack. It is also possible to administer a dose of sublingual nitroglycerin that relieves the associated pain of angina in a matter of minutes. These methods of testing will confirm if these attacks are in fact angina attacks.
There are also tests that are performed to establish the intensity of the ischaemia and also to identify probable coronary artery disease. The tests will generally be carried out using electrocardiogram (ECG), echocardiogram, x-rays of the chest, exercise tolerance test, thallium stress test, coronary angiogram and or cholesterol and blood tests to analyse total fat, lipoproteins and cholesterol levels.
A part of the treatment will include personal management and changes in lifestyle.
- It will be necessary to decrease or completely stop smoking which will significantly worsen the progression of the disease.
- It will require a change in diet and a strict adherence to nutritional guidelines that will dictate the levels of fat and cholesterol that should be consumed daily; essentially this will be a low fat and low cholesterol diet.
- Drugs may be administered to lower cholesterol levels.
- An exercise regimen will be suggested to greatly improve overall health.
- A method of stress management and reduction may be recommended.
- If hypertension is present treatment for that condition with a low sodium diet and medication will be critical.
- Maintaining an ideal body weight will also greatly improve the chances of managing the disease.
- A balloon angioplasty may be incorporated. This will involve the use of a small uninflated balloon that will be passed up the affected artery and inflated to free the obstruction. Though this type of treatment will alleviate many of the associated symptoms of the disease it will not necessarily control the disease itself.
- In extreme cases it may be vital to have bypass surgery performed. This will in effect, bypass the affected coronary arteries.
- Treatment may also include medications such as nitrates, calcium channel antagonists, beta blockers and anti-platelet drugs. Beta blockers will lower the heart rate when resting thus decreases the demand for oxygen. Nitrates will eliminate an angina attack. Calcium channel blockers will hinder blood vessel constriction and consequently prevent artery spasm. Anti- platelet drugs like aspirin will prevent platelets from sticking to blood vessel walls therefore reducing the likelihood of further narrowing of the vessels.
- If the disease has progressed beyond repair or when normal treatment is not applicable then a heart transplant may have to be performed.
If treatment ensues before grave damage is done to the heart then the outlook is generally fair. Adopting a doctor regulated regimen will improve overall quality of life and longevity. It is possible for aggressive treatments to hinder the course of the disease and reverse some of the damage that has already occurred. The long term forecast for the disease will be contingent upon several factors, including: the ability of the heart to pump effectively, the extent or progression of the disease when identified and age upon diagnosis.
Preventing Heart Disease in General
Having a knowledge of the associated risk factors and measures to successfully reduce the development of heart disease can be useful in minimizing the likelihood of being affected by it. Eliminating smoking, incorporating a good exercise routine into daily life, consuming less fatty foods, controlling other pre-existing conditions like diabetes and hypertension and maintaining an ideal body weight are fairly good measures to lessen the probability of being afflicted by any of these types of heart disorders.