For those who often experience chest pain, feeling like something is squeezing or pressing down, be cautious! Because this may be a warning sign that you are experiencing “ischemic heart disease”.
The important “cause” of ischemic heart disease that should not be overlooked
Ischemic heart disease occurs when the coronary arteries that supply blood to the heart become hardened (Ateriosclerosis) due to the accumulation of substances on the inner walls of the arteries, mostly fats. This causes the artery walls to thicken, narrow, or become blocked. The elasticity of the arteries decreases, reducing or completely stopping blood flow to the heart muscle, leading to ischemia and heart muscle death, which can cause sudden death without warning. Other factors that promote coronary artery narrowing include high blood pressure, diabetes, high blood cholesterol, and aging.
Danger signs… when the heart muscle is ischemic
The main symptom of ischemic heart disease is chest pain in the middle of the chest just above the sternum, described as a tight, squeezing pain, like something pressing or a heavy object on the chest. The pain often radiates to the left shoulder and left arm. It usually occurs during exercise, heavy physical work, or when angry, stressed, or excited. When the exertion or emotional stress stops, the chest pain usually subsides. This is a symptom of temporary heart ischemia. However, if the coronary artery is completely blocked and blood cannot reach the heart muscle, causing part of the heart muscle to die, severe and prolonged chest pain occurs. Relatives should urgently take the patient to the hospital as soon as possible because shock and heart failure may also occur.
How to check if the heart muscle is ischemic?
- Start by reviewing medical history, underlying diseases, treatment history, and the characteristics of chest pain. Check if the pain is related to exertion or stress, how long it lasts, and perform a general physical examination including blood pressure measurement to assess disease severity.
- Electrocardiogram (ECG) during treadmill exercise (Exercise Stress Test) to observe changes in the heart’s electrical activity during exercise, when the heart requires more blood. If the heart muscle is dying, changes in the ECG will be detected.
- Blood tests to measure chemical markers that indicate heart muscle death. This method can diagnose the severity of the disease.
- Coronary angiography (dye injection into coronary arteries) allows doctors to definitively diagnose whether the coronary arteries are narrowed and to what extent.
More than one treatment method for ischemic heart disease
In treatment, doctors consider multiple factors to decide the appropriate method. The main factors are disease severity, coronary artery pathology, and patient symptoms. Treatment options include medication, coronary angioplasty with balloon dilation, and coronary artery bypass graft surgery (Coronary Artery Bypass Grafting).
Method 1: Medication treatment
Doctors will prescribe vasodilators for the coronary arteries, such as nitroglycerin, to be taken sublingually immediately when symptoms occur. Sometimes, blood clot prevention drugs like aspirin are given once daily. For patients with underlying diseases such as hypertension, diabetes, or high cholesterol, doctors will also prescribe medications to control these conditions concurrently.
Method 2: Coronary angioplasty with balloon dilation
Doctors consider this method for severe coronary artery narrowing or heart muscle death that cannot be treated with medication. It involves expanding the narrowed coronary artery with a balloon to improve blood flow to the heart muscle. A small catheter is inserted through the femoral artery in the groin. At the tip of the catheter is a tiny deflated balloon. When the balloon reaches the narrowed artery, the doctor inflates it to compress the plaque against the artery wall, widening the artery. The balloon is then removed. In some cases, a small wire mesh (stent) may be placed in the narrowed area to prevent re-narrowing.
Method 3: Coronary artery bypass surgery (Bypass)
Bypass surgery is considered for severe coronary artery narrowing. Doctors base the decision mainly on the artery pathology and patient symptoms. The surgery creates new pathways by grafting new blood vessels to bypass the blocked arteries, allowing blood to flow to the heart through new routes. Typically, 3-5 vessels are grafted. After surgery, patients must continue medication to prevent re-narrowing of the arteries.
Where do the new blood vessels for bypass come from?
When selecting blood vessels for bypass grafting, doctors consider several factors such as the elasticity and thickness of the vessel walls and the patient’s overall condition. Commonly used vessels are the arteries from the chest and veins from the legs.
“Self-care” when having ischemic heart disease
Patients should strictly follow their doctor’s medication instructions and eat a healthy diet focusing on vegetables and fruits while avoiding high-fat and very salty foods. It is also beneficial to avoid tea, coffee, and smoking. Remember to exercise regularly and get enough rest.
How to “prevent” ischemic heart disease?
We can protect ourselves by choosing a healthy diet low in fat and high in fiber, such as vegetables, fruits, and fish. Exercise regularly at least 3 times a week, maintain a healthy weight, avoid excessive sweets, avoid smoking, get enough rest, and learn to manage stress. Annual health check-ups are recommended. For those with underlying diseases, regularly see a doctor and take medications as prescribed, such as for diabetes and hypertension. If chest pain occurs, consult a doctor immediately.
