Lectures notes - Ischaemic Heart Disease

Ischaemic Heart Disease (IHD) Overview

Ischaemic Heart Disease (IHD), also known as coronary artery disease (CAD), is characterised by
reduced blood flow to the heart muscle, typically due to atherosclerosis in the coronary arteries. This
can lead to symptoms such as angina or myocardial infarction (MI)

Pathophysiology

Atherosclerosis: The narrowing of coronary arteries by plaque formation (cholesterol, lipids, and
fibrous tissue) reduces oxygen supply to the heart muscle.

Ischaemia: Reduced blood flow causes myocardial ischemia. Prolonged ischemia can lead to
irreversible myocardial damage (myocardial infarction).

Plaque Instability: Plaques may rupture, leading to thrombus formation, causing sudden blockage of
the coronary artery and acute coronary syndrome (ACS).

Risk Factors

According to NICE, risk factors include:

Modifiable:

Smoking

Hypertension

Dyslipidemia (high LDL, low HDL)

Diabetes

Sedentary lifestyle

Poor diet (high in saturated fat, low in fiber)

Obesity

Non-Modifiable:

Age: Risk increases with age.

Gender: Males are at higher risk; post-menopausal women have similar risks.

Family History: A strong predictor of premature IHD.

Clinical Presentation

IHD typically presents as stable angina, unstable angina, or myocardial infarction.