Stable Ischemic Heart Disease: Symptoms, Diagnosis, and Treatment
Stable ischemic heart disease (SIHD) is a leading cause of death in the United States characterized by symptoms of angina, chest pressure, arm discomfort, shortness of breath, and jaw discomfort. In this brief article, Jesal V. Popat, M.D., FACC, one of the top Tampa Bay cardiac specialists, discusses the symptoms of SIHD in greater detail, the process of diagnosis, and methods of treatment.
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Stable ischemic heart disease is most commonly a result of atheromatous plaques in the coronary arteries that obstruct blood flow and cause anginal symptoms to manifest. In certain patients, particularly women, ischemia may be brought on by vascular dysfunction of myocardial vessels without obstruction of epicardial vessels. The most noticeable presentation of SIHD is that of chest discomfort during exertion or emotional stress, although it can manifest in atypical presentations, such as discomfort in the jaw, neck, or arms. Once again, these atypical presentations are more commonly found in women, as well as individuals with diabetes.
That being said, typical stable angina as caused by SIHD lasts a short period of time (roughly five minutes or less) and is relieved by rest or nitroglycerin. You may experience other symptoms in addition to chest pain and discomfort, such as dizziness, fatigue, shortness of breath, nausea, and sweating. This is different from unstable angina, which is classified as a medical emergency, because it does not occur while at rest, last up to thirty minutes or longer, or potentially signal a heart attack. If you are experiencing chest pain that does not go away when you rest or that lasts thirty minutes or longer, it may be a sign you are having a heart attack and you should contact emergency medical help.
Prior to discussing the diagnosis of SIHD, it is important to recognize the common risk factors for the disease: hypertension, diabetes, hyperlipidemia, obesity, smoking, and a family history of heart attacks. If you are experiencing ischemic symptoms, such as chest discomfort during strain or emotional stress, then a coronary angiography will be performed in order to determine the severity and extent of the disease and whether or not you will be a candidate to undergo coronary revascularization. In addition to or in lieu of a coronary angiography, a cardiac stress test may be performed to evaluate your heart’s capacity to respond to external stress in a controlled environment. Once again, all of which is used to determine whether or not you can benefit from a coronary revascularization.
Generally speaking, the treatment for SIHD falls into two categories: the prevention of ischemic events, such as heart attack and stroke, and reduction of the symptoms of angina. Not all methods of treatment will both reduce the symptoms of angina as well as help to prevent ischemic events. For example, coronary revascularization has been shown to reduce angina symptoms but not necessarily reduce the likelihood of ischemic events. An article published in the academic medical journal Annals of Internal Medicine on SIHD instead recommends a combination of appropriate treatments, known as guideline-directed medical therapy (GDMT).
GDMT involves the patient becoming educated on the underlying disease process and working with their medical provider to establish treatment options that focus on their prognosis and risk factors. The treatment method should emphasize lifestyle modifications, reduction of risk factors, and behavioral changes, such as taking antihypertensive medication and working towards an improved diet and exercise. For more information on preventative measures or to design a customized treatment plan for your SIHD, contact Jesal V. Popat, M.D., FACC, today.
To consult Jesal V. Popat, M.D., FACC, one of the best Tampa cardiac specialists, please call (813) 344-0934 or fill out our contact form to schedule an appointment.
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