Cardiovascular system Ischemic cardiopathy

Ischemic cardiopathy or coronary arterial disease is a term used to define narrowings of the coronary arteries, which take oxygen-rich blood to the heart.

The narrowing of the coronary arteries is caused by the atherosclerosis, which is the process of artery aging where atheroma (fat) plaques form inside them as the time passes. With such plaques, the vessel reduces its internal diameter, causing difficulty for the blood passage and so causing a reduction in the blood flow to the heart (ischemia).

Figure 1. Coronary arteries and atheroma plaque

The ischemic cardiopathy is a silent disease. The first sign of the disease is sudden death or acute myocardial infarction in almost half the cases. Therefore, check-ups and preventive exams are important to detect and treat the disease before it causes irreversible damage.

Angina

The heart needs more blood in an exercise and, where there is a coronary narrowing, such increase in flow is not possible, causing angina by effort.

Pain may appear at small efforts or even at rest with the disease worsening (unstable angina or acute coronary syndrome). In the latter situations, there is need for hospitalization and, usually, intervention.

The treatment will depend on the severity of the symptoms and on the degree of impairment of the coronary arteries. It can be clinical, with an angioplasty, or with a revascularization surgery.

Infarct

An infarct occurs when there is a full obstruction of a coronary artery. This means that a portion of the cardiac muscle is without circulation and dies. Also called heart attack or acute myocardial infarction, the infarct may cause a strong pain in the chest radiating to the neck and left arm. Other symptoms such as shortness of breath, nausea, and discomfort feeling in the chest or stomach may occur. The time elapsed between the beginning of the pain in the infarct and the treatment is important to save cardiac muscle. In an acute infarction, it is important to open the coronary artery that was obstructed. This can be performed with drugs (thrombolytics) or primary angioplasty.

A cardiac catheterization will show the anatomy of the coronary arteries and the degree of impairment of them and, together with the clinical condition, these will help us to define which is the best treatment form: if it is clinical, with angioplasty, or with myocardial revascularization surgery.

ANGINA AND INFARCT ARE CONSEQUENCES OF THE FORMATION OF FAT PLAQUES INSIDE THE ARTERIES, WHERE THERE IS A DECREASE IN THE BLOOD FLOW TO THE HEART (ANGINA) OR A FULL OBSTRUCTION OF AN ARTERY, CAUSING THE DEATH OF THE CARDIAC MUSCLE (INFARCT).

Support notes

Angioplasty: Dilation with a balloon of an artery narrowed by fat plaques. Click here to go to the page of Angioplasty and to know more about this subject.

Revascularization surgery: This is a type of cardiac surgery where a bypass is made over the narrowed or obstructed place, so improving the blood and oxygen flow to the heart.

Catheterization: Exam where a catheter is placed inside the arterial system until the desired place. Click here to go to the page of Catheterization and to know more about this subject.

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