Chronic ischemic heart disease

Myocardial ischemia is a condition caused by a mismatch between myocardial tissue oxygen supply and demand.

The main cause is coronary atherosclerosis, a pathological process characterized by the presence of lipid plaques within the coronary arteries walls.
These plaques could:
  • slowly grow causing obstructive coronary artery disease,
  • break causing sudden occlusion of the vessel lumen due to the a thrombus formation,
  • alter the regulation process of vessel resistance and, therefore, cause vasospasms.

The evolution of the atherosclerotic process could be modified by lifestyle, medication or invasive therapeutic interventions (i.e. angioplasty).

The most common symptoms are:
  • oppressive or burning chest discomfort, generally, is localized:
    • in the chest with a probable irradiation to the neck or jaw
    • to the epigastrium
    • to both arms
    • to the shoulders
  • breathlessness
  • weakness
  • nausea
  • loss of consciousness

In chronic ischemic heart disease, symptoms are exacerbated by physical exertion, emotional stress, a heavy meal, after waking up and are relieved with rest or by taking the sublingual nitrates.

Therefore, this area of care includes patients with:
  • suspected stable angina pectoris and/or dyspnoea:
    • not rest angina
    • not new-onset angina (i.e. 2 months onset angina)
    • no crescendo angina (i.e. angina which progressively increases in severity and intensity)
  • recent diagnosis of heart failure or left ventricular dysfunction and clinical likelihood of coronary artery disease (i.e. age, family history of early cardiovascular disease, dyslipidemia, hypertension, diabetes mellitus, smoking, obesity, sedentary lifestyle)
  • confirmed coronary artery disease at screening
  • prior coronary revascularization and prior acute coronary syndrome
  • suspected vasospastic or microcirculatory disorder angina.

Our Team, specialized in ischemic heart disease, will take care of:
  • assess the clinical likelihood of obstructive coronary artery disease,
  • define the initial diagnostic management of patients with suspected obstructive coronary artery disease,
  • help individuals to achieve a healthy lifestyle to prevent the coronary artery disease progression.

Reference: European Heart Journal (2020) 41, 407-477

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