Ischemic heart disease (IHD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium; it typically occurs when there is an imbalance between myocardial oxygen supply and demand.


1.Coronary Arterial Syndrome(CAD)-Stable Angina

2.Acute Coronary Syndrome

  1. Non-ST-Segment Elevation Myocardial Infarction (partial blockage )
  2. ST-Segment Elevation Myocardial Infarction -Unstable Angina(complete blockage)


  1. Plaques made up mostly of cholesterol build up on your artery walls and restrict blood flow. Atherosclerosis is the most common cause of myocardial ischemia.
  2. Blood clot.The plaques that develop in atherosclerosis can rupture, causing a blood clot. The clot might block an artery and lead to sudden, severe myocardial ischemia, resulting in a heart attack.
  3. Coronary artery spasm.
  4. Smoking and long-term exposure to secondhand smoke can damage the inside walls of arteries. The damage can allow deposits of cholesterol and other substances to collect and slow blood flow in the coronary arteries. Smoking causes the coronary arteries to spasm and may also increase the risk of blood clots.
  5. High blood pressure.
  6. Obesity
  7. High blood cholesterol level.Cholesterol is a major part of the deposits that can narrow your coronary arteries. A high level of “bad” (low-density lipoprotein, or LDL) cholesterol in your blood may be due to an inherited condition or a diet high in saturated fats and cholesterol.
  8. High blood triglyceride level.
  9. Lack of physical activity.Not getting enough exercise contributes to obesity and is linked to higher cholesterol and triglyceride levels.
  10. Depression
  11. Emotional stress
  12. Lack of fiber in foods
  13. Metabolic syndrome.
  14. Illicit drug use. Using stimulant drugs, such as cocaine or amphetamines
  15. Family history of heart attacks
  16. A history of preeclampsia.This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease.
  17. An autoimmune condition.Having a condition such as rheumatoid arthritis or lupus can increase your risk of a heart attack.


Heart attack triggered by:

  • Physical exertion
  • Emotional stress
  • Depression
  • Anxiety
  • Cold temperatures
  • Cocaine use
  • Eating a heavy or large meal
  • Sexual intercourse
  • Anger
  • Fright
  • Frustration


Chest discomfort, usually described as heaviness, pressure, squeezing, smothering, or choking and only rarely as frank pain. The pain is deep and visceral; heavy, and crushing; although, occasionally, it is described as stabbing or burning

When the patient is asked to localize the sensation, he or she typically places a hand over the sternum, sometimes with a clenched fist, to indicate a squeezing, central, substernal discomfort (Levine’s sign).

Angina is usually crescendo-decrescendo in nature, typically lasts 2–5 min, and can radiate to either shoulder and to both arms (especially the ulnar surfaces of the forearm and hand). It also can arise in or radiate to the back, interscapular region, root of the neck, jaw, teeth, and epigastrium.






Sense of impending doom

Painless MI is greater in patients with diabetes mellitus, and it increases with age

Most patients are anxious and restless, attempting unsuccessfully to relieve the pain by moving about in bed, altering their position, and stretching

Coolness of the extremities occurs commonly


  • Dietary salt restriction
  • Reduce your weight
  • Regular exercise
  • Avoid alcohol
  • Avoid tobacco
  • Quit smoking
  • Eat organic food
  • Avoid pesticides, weedicide
  • Avoid artificial carbonated drinks
  • Avoid allopathic pain killer


During the initial stage, total occlusion produces ST-segment elevation. Most patients initially presenting with ST-segment elevation ultimately evolve Q waves on the ECG.

Cardiac-specific troponin T increase

Cardiac-specific troponin I increase

CK-MB increase

Echo cardiogram




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