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Heart health topic for the week

Myocardial ischaemia

Diagnosis

Your doctor will begin by inquiring about your medical history and conducting a physical examination. Following this, your doctor may recommend several diagnostic tests:

  1. Electrocardiogram (ECG): Electrodes attached to your skin record the electrical activity of your heart. Changes in this activity can indicate heart damage.
  2. Stress Test: This test monitors your heart rhythm, blood pressure, and breathing while you walk on a treadmill or ride a stationary bike. By making your heart work harder, a stress test can reveal heart issues not evident under normal conditions.
  3. Echocardiogram: Using sound waves directed at your heart, a wand-like device captures video images of your heart. This test helps identify areas of your heart that may be damaged and not functioning properly.
  4. Stress Echocardiogram: Similar to a regular echocardiogram, this test is performed after you exercise on a treadmill or stationary bike in the doctor’s office.
  5. Nuclear Stress Test: Small amounts of radioactive material are injected into your bloodstream. While you exercise, your doctor observes the flow of this material through your heart and lungs, identifying any blood flow problems.
  6. Coronary Angiography: A dye is injected into the blood vessels of your heart, and a series of X-ray images (angiograms) are taken to track the dye’s path. This test provides a detailed view of the inside of your blood vessels.
  7. Cardiac CT Scan: This scan can detect the buildup of calcium in your coronary arteries, which is a sign of coronary atherosclerosis. Additionally, coronary CT angiograms can visualize the heart arteries using CT scanning.

These tests help your doctor gain a comprehensive understanding of your heart health and identify any potential issues.

Treatment

The primary objective of treating myocardial ischemia is to enhance blood flow to the heart muscle. Depending on the severity of your condition, your doctor may suggest medications, EECP therapy, surgical procedures, or a combination of 2 or 3 of them.

Medication

Medications used to treat myocardial ischaemia include:

  1. Aspirin: Taking a daily aspirin or other blood thinner can reduce the risk of blood clots, which may help prevent blockages in your coronary arteries. Consult your doctor before starting aspirin, especially if you have a bleeding disorder or are already on another blood thinner.
  2. Nitrates: These drugs dilate arteries, improving blood flow to and from the heart, reducing the workload on your heart.
  3. Beta Blockers: These medications help relax the heart muscle, slow the heartbeat, and lower blood pressure, facilitating easier blood flow to the heart.
  4. Calcium Channel Blockers: These drugs relax and widen blood vessels, enhancing blood flow in the heart. They also slow the pulse and reduce the heart’s workload.
  5. Cholesterol-lowering Medications: These drugs decrease the amount of cholesterol that can deposit on coronary arteries.
  6. Angiotensin-Converting Enzyme (ACE) Inhibitors: These medications relax blood vessels and lower blood pressure. They may be recommended if you have high blood pressure, diabetes, heart failure, or if your heart is not pumping blood effectively.

Procedures to Improve Blood Flow

Procedures that may be recommended include:

  1. Angioplasty and Stenting: A catheter is inserted into the narrowed part of the artery, and a tiny balloon is inflated to widen the artery. A small wire mesh coil (stent) is usually placed to keep the artery open.
  2. Coronary Artery Bypass Surgery: A surgeon uses a vessel from another part of your body to create a graft that allows blood to bypass the blocked or narrowed coronary artery. This open-heart surgery is typically used for those with multiple narrowed coronary arteries.
  3. Enhanced External Counterpulsation (EECP also known as ECP): This is the only noninvasive treatment that will improve blood flow. Cuffs wrapped around your legs are inflated and deflated with air, applying pressure to your blood vessels and improving blood flow to the heart. We provide this treatment here at Vasoflo.

These treatments aim to restore adequate blood flow to the heart, alleviating symptoms and reducing the risk of more serious heart issues.

Self-Care

Lifestyle changes play a crucial role in the treatment of myocardial ischaemia. To adopt a heart-healthy lifestyle, consider the following:

  1. Quit Smoking: Consult your doctor about strategies to quit smoking and try to avoid exposure to secondhand smoke.
  2. Manage Underlying Health Conditions: Address conditions that increase your risk of myocardial ischemia, such as diabetes, high blood pressure, and high blood cholesterol.
  3. Eat a Healthy Diet: Limit saturated fats and consume plenty of whole grains, fruits, and vegetables. Monitor your cholesterol levels and consult your doctor to ensure they are within the recommended range.
  4. Exercise: Discuss with your doctor a safe exercise plan to enhance blood flow to your heart.
  5. Maintain a Healthy Weight: If you are overweight, seek advice from your doctor on weight-loss options.
  6. Decrease Stress: Practice stress management techniques like muscle relaxation and deep breathing exercises.

Regular medical checkups are essential, as key risk factors for myocardial ischaemia—high cholesterol, high blood pressure, and diabetes—often show no symptoms in their early stages. Early detection and treatment can lead to better heart health over the long term.

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