Coronary Heart Disease, Ischemic Heart Disease (IHD ,CHD)

A disease characterized by decreased blood flow in the coronary arteries resulting from stenosis.

In most cases, these stenoses (narrowing) is caused by Atherosclerosis, a process in which lipid plaques are formed upon the arterial wall, whereby the lumen is narrowed and less blood can flow in them at any given moment.

If the oxygen requirement at a given time exceeds the possible supply by the stenosed Coronary artery, relative oxygen deficit ensues. This deficit is called Ischemia.

Ischemia can cause biochemical, electrical and temporary functional alterations in the heart and the patient usually experiences distressing pressure pain in the front of the chest, which is known as Angina Pectoris.

The course of Ischemic disease depends on the extent of the lipid plaques, their localization and the processes occurring in them.

If a lipid plaque grows slowly and is stable, gradual appearance of symptoms is the rule, known as stable Angina Pectoris. The characteristic trait of this form of the disease is the appearance of Ischemia when the demand for oxygen exceeds the supply.

Because the highest oxygen requirement occurs during strenuous heart action, physical exercise or mental stress are known triggers for the appearance of ischemic pain.

If processes inside the lipid plaque cause the rupture of its envelope with creation of a blood clot (thrombus) on its surface, the course of ischemic disease can become stormy and result in myocardial infarction, rhythm disturbances and even sudden death.