What is ischemic heart disease? Symptoms and treatment options

  • Ischemic heart disease is the most common type of heart disease and is caused by narrowed heart arteries.
  • The most common symptom is chest discomfort that feels like squeezing and gets worse with exertion; other symptoms are shortness of breath, pain in the jaw, or excessive sweating. 
  • Most types of ischemic heart disease can be treated with lifestyle modifications, medications, or a pacemaker.
  • This article was reviewed by John Osborne, MD, PhD, and the Director of Cardiology for Dallas-based State of the Heart Cardiology.
  • Visit Insider’s homepage for more stories.

Ischemic heart disease, also known as coronary artery disease, is the most common type of heart disease. It affects about 18 million adults over age 20 in the US, according to the Centers for Disease Control and Prevention (CDC). 

Here’s what you need to know about the different types of ischemic heart disease, common symptoms, and the biggest risk factors. 

What is ischemic heart disease

Ischemic heart disease (IHD) refers to heart problems caused by narrowed heart arteries. This is commonly the result of plaque build-up in the arteries, resulting in a reduction of blood flow to the heart, which can cause a heart attack

IHD can also contribute to abnormal and potentially dangerous heart rhythm problems, says Scott Maffett, MD, a cardiologist at the Ohio State University Wexner Medical Center. 

There are three main types of ischemic heart disease: 

  • Obstructive coronary artery disease is the result of plaque build-up that causes the heart’s large arteries to gradually narrow, reducing and eventually blocking the supply of blood flow to the heart.
  • Nonobstructive coronary artery disease occurs when large arteries are narrowed by plaque build-up, but not completely obstructed.
  • Coronary microvascular disease affects the heart’s smallest arteries and is typically the result of molecular changes in the blood vessels of the heart, preventing blood flow through the small arteries. 

Symptoms of IHD vary, but the most common are chest discomfort, typically in the center or left side of the chest that may feel like squeezing or pressure and worsens with exertion, Maffett says. Some people may also experience shortness of breath, pain in their jaw, or excessive sweating. 

These are similar to the symptoms of a heart attack, and if you are experiencing persistent or severe chest pain, you should seek immediate medical treatment. 

You may not feel symptoms with ischemic heart disease 

While most people with IHD do exhibit symptoms, it is possible for some people to experience a heart attack and not feel it, Maffet says. This is known as silent ischemia, or a silent heart attack, and can result in heart failure since the person experiencing the heart attack isn’t aware and doesn’t seek treatment. 

People who have had a previous heart attack are especially at risk for silent ischemia as well as people with diabetes, since diabetes can cause nerve disease, decreasing the diabetic patient’s ability to feel the pain from a heart attack.  Undergoing an exercise stress test can help diagnose silent ischemia. 

There are also many signs that can indicate an increased risk for any type of IHD. Maffett says the most common risk factors include smoking, diabetes, high blood pressure, high cholesterol, a family history of heart disease, poor diet, and lack of exercise. 

All of these factors contribute to the buildup of plaque in your arteries, which can result in a decrease in blood flow and oxygen to the heart. But there are ways to reverse plaque buildup and restore a healthier heart. 

How to treat ischemic heart disease

Maffett says most types of IHD are treatable with lifestyle modifications, medications, or sometimes a pacemaker, which is a small device placed in your chest to help control your heartbeat. 

Lifestyle changes to treat IHD include quitting smoking, increasing physical activity, losing weight, and reducing stress. Medications commonly include aspirin, statins, beta-blockers, and ACE inhibitors. 

If you have several blocked arteries or your left main coronary artery is severely narrowed, you may require coronary bypass surgery to redirect blood flow around the blocked or damaged arteries. 

To learn more about ischemic heart disease, also known as coronary artery disease, read our article, “What causes coronary artery disease? Who’s most at risk and treatment.” 

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