Ischemic Heart Disease (IHD)

 

• Background

  • IHD (aka coronary heart disease, coronary artery disease) is the presence of symptoms or signs of cardiac ischaemia.
  • Commonest ischaemia cause is atherosclerosis, the formation of lipid-laden plaques in coronary artery walls.
  • Symptoms occur when plaques (a) grow and obstruct the vessel, causing angina, or (b) rupture and form a thrombus, occluding the vessel and causing an acute coronary syndrome.

• Presentation

  IHD can present with angina or acute coronary syndrome (ACS).

• Risk factors

  Modifiable RFs:

  • HTN
  • Dyslipidaemia: ↑TC, ↑TC:HDL ratio, ↑LDL.
  • Diabetes
  • Smoking
  • Excess alcohol
  • Obesity

  Fixed RFs:

  • Age
  • Male
  • South Asian ethnicity.
  • Medical history of atheroma: MI, stroke, or PVD.
  • Family history: MI in 1st degree relative, male < 55 years, female < 65 years.