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Stable Ischemic Heart Disease

  • Santosh K. Padala
  • Mandeep S. Sidhu
  • William E. BodenEmail author
Living reference work entry

Later version available View entry history

Abstract

Ischemic heart disease (IHD) results from an inadequate supply of blood flow and oxygen to an area of myocardium, typically resulting from a mismatch of myocardial oxygen demand and supply. IHD may have either acute or chronic presentations, and most commonly results from a significant stenosis of greater than 70 % in one or more of the major epicardial coronary arteries secondary to an atherosclerotic plaque which, in acute disease expressions, may rupture or fissure, while in more chronic expressions, typically results from a slowly advancing constrictive process that compromises the arterial lumen. Increasingly, attention is being directed to IHD that may occur in the absence of epicardial coronary artery narrowing such as is observed in patients (most often women) who may exhibit so-called microvascular angina due to involvement of the arteriolar resistance vessels that results in impaired coronary vasodilator reserve. Other non-atherosclerotic causes of IHD include congenital anomalies of the coronary vessels, myocardial bridging, coronary arteritis in association with the systemic vasculitides, and radiation-induced coronary disease. Furthermore, IHD may also occur in the absence of obstructive coronary artery disease (CAD), as in the case of uncontrolled hypertension, aortic valve disease, hypertrophic cardiomyopathy, and idiopathic dilated cardiomyopathy. Moreover, CAD may coexist with these other forms of heart disease.

The term IHD encompasses a spectrum of manifestations that vary from asymptomatic/silent myocardial ischemia to stable (chronic) angina pectoris, as well as more acute manifestations that include Prinzmetal (variant) angina, unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). In addition, individuals with IHD may initially present with signs and symptoms of heart failure, arrhythmias, and potentially sudden cardiac death.

Keywords

Coronary Compute Tomographic Angiography Fractional Flow Reserve Spinal Cord Stimulation Optimal Medical Therapy Isosorbide Dinitrate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Glossary of Terms

Angina

Chest pain, pressure, or tightness caused by decreased blood supply to the heart

Cardiac catheterization

A minimally invasive procedure to diagnose coronary artery disease where a catheter is inserted in to an artery in the arm or leg, followed by injection of contrast dye. The dye fills up the coronary arteries and heart cavity, and X-ray pictures are taken

Coronary artery bypass grafting

A surgical procedure where the diseased coronary arteries are bypassed using venous or arterial grafts, to enhance blood supply to the heart muscle

Coronary artery disease

A gradual accumulation of the lipid-laden material (plaque) in the wall of the coronary artery leading to the narrowing of the lumen of the artery

Ischemic heart disease

Heart disease caused by inadequate supply of oxygenated blood to the heart muscle due to narrowing of the coronary arteries

Myocardial infarction

Permanent damage of the heart muscle due to inadequate blood supply for a prolonged period of time

Percutaneous coronary intervention

A procedure performed during cardiac catheterization where a stent is deployed at the site of significant obstruction or narrowing in the coronary artery to improve blood supply to the heart muscle

Abbreviations

ACS

Acute coronary syndromes

CABG

Coronary artery bypass grafting

CAD

Coronary artery disease

CCS

Canadian Cardiovascular Society

ECG

Electrocardiography

IHD

Ischemic heart disease

LV

Left ventricle

MI

Myocardial infarction

NSTEMI

Non-ST-segment elevation myocardial infarction

NYHA

New York Heart Association

OMT

Optimal medical therapy

PCI

Percutaneous coronary intervention

PTCA

Percutaneous transluminal coronary angioplasty

SIHD

Stable ischemic heart disease

STEMI

ST-segment elevation myocardial infarction

UA

Unstable angina

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Book Chapters

  1. Morrow DA, Boden WE (2011) Stable ischemic heart disease. In: Braunwald’s heart disease: a textbook of cardiovascular medicine, 9th edn. Elsevier Saunders, Philadelphia, pp 1210–1269Google Scholar
  2. Sidhu MS, Boden WE (2013) Asymptomatic CAD & silent ischemia: roles of stress testing, myocardial imaging, optimal medical therapy, and myocardial revascularization. Clinical Decision SupportGoogle Scholar
  3. Théroux P (2008) Angina pectoris. In: Goldman L, Ausiello DA (eds) Cecil textbook of medicine, 23rd edn. Saunders Elsevier, PhiladelphiaGoogle Scholar

Further Reading

  1. Morrow DA, Boden WE (2011) Stable ischemic heart disease. In: Braunwald’s heart disease: a textbook of cardiovascular medicine, 9th edn. Elsevier Saunders; pp 1210–1269. This chapter provides an excellent and comprehensive review on stable ischemic heart diseaseGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Santosh K. Padala
    • 1
  • Mandeep S. Sidhu
    • 2
  • William E. Boden
    • 2
    Email author
  1. 1.Department of Medicine, Division of CardiologyAlbany Medical CenterAlbanyUSA
  2. 2.Department of Medicine, Division of CardiologyAlbany Medical Center, Samuel S. Stratton VA Medical CenterAlbany StrattonUSA

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