Overview

Ischemic heart disease (IHD) is a condition in which the heart muscle does not receive sufficient blood and oxygen due to the narrowing of the arteries that supply it. This usually happens slowly over time because fat builds up on the inside walls of the arteries. At first, the heart can still handle it, but as the narrowing worsens, it becomes harder to receive enough oxygen-rich blood. A lot of people don't notice anything at first, which is why it often grows slowly over the years before symptoms show up.

Symptoms
The most common sign is chest pain, often described as pressure, tightness, or heaviness in the middle of the chest. It might start when you do something or are stressed, and it might get better when you rest. Some people also have trouble breathing, feel tired, or feel a burning or squeezing feeling in their chest. The pain can move to the back, neck, jaw, or arm. Not everyone has the usual symptoms. For example, people with diabetes may only feel mild discomfort or unusual tiredness. In some cases, the first sign could be a heart attack.

Causes
Atherosclerosis is the main cause of IHD. It happens when cholesterol and fat build up in the arteries. This makes the vessels narrower over time, slowing blood flow. High cholesterol, high blood pressure, diabetes, smoking, being overweight, and not getting enough exercise are all risk factors. Stress and eating poorly are also factors. Age and family history raise the risk, which means that some people are more likely to get sick even if they live the same way.

Diagnosis
The first step in diagnosis is a clinical evaluation, which involves identifying which symptoms and risk factors are present. An ECG and other tests can show how the heart is working, and blood tests can show signs of stress or damage. People often use a stress test to see how well the heart functions under stress. Echocardiography and CT scans are two imaging tests that can provide additional information. In some cases, coronary angiography is performed to directly visualize coronary artery blockages.

Treatment
The goal of treatment is to improve blood flow. Making lifestyle changes is very important. Eating well, working out regularly, quitting smoking, and managing stress all make a big difference. Doctors often prescribe medication to lower cholesterol and blood pressure, and to reduce the risk of blood clots. In more serious cases, you may need procedures like angioplasty (with stent placement) or bypass surgery. Many people can control their condition and live active, stable lives with regular care and follow-up.