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Ischemic Heart Disease Diagnosis

Ischemic heart disease, known also as ischemic cardiomyopathy or coronary artery disease, is a condition characterized by a reduced flow of blood to the heart. Its principal cause is a buildup of plaque on the linings of the coronary arteries that restricts blood flow, depriving the heart of all the oxygen it needs to function properly.

  1. Signs and Symptoms

    • The early stages of ischemic heart disease are asymptomatic in some patients, making it possible for the condition's damaging effects to progress largely undetected, according to RxMed.com. Eventually, however, symptoms of either angina or congestive heart failure (CHF) are likely to appear, says MedlinePlus. The most notable symptom of the former is a chest pain that appears centered behind the breast bone or slightly to its left. Other symptoms include shortness of breath, dizziness and fatigue. Shortness of breath is also a sign of CHF, as are swelling of the ankles and feet, loss of appetite, persistent cough, palpitations and an irregular pulse.

    Seeking a Diagnosis

    • If you are experiencing the symptoms of either angina or CHF, you should see your doctor immediately. You also should check with your doctor if you have a family history of heart disease or suspect you may be developing heart problems. Your doctor can assess the situation, starting with a physical exam, and then order the diagnostic tests that he deems appropriate.

    Ejection Fraction

    • CHF, one of the two main conditions likely to result from ischemic heart disease, is characterized by a compromised ejection fraction, a measurement of the heart's efficiency. MedicineNet.com defines ejection fraction as "the portion of blood that is pumped out of a filled ventricle as a result of a heartbeat." The normal ejection fraction is between 55 and 65 percent. Your doctor may order a series of tests to pinpoint your ejection fraction. Such tests may include an electrocardiogram, echocardiogram, MRI scan of your chest, or a ventriculogram (performed during a cardiac catheterization).

    Other Diagnostic Tests

    • As a follow-up to a reading on your ejection fraction, your doctor may order a myocardial biopsy, a tissue sample of your heart muscle that is obtained most often during a cardiac catheterization. Other tests that are helpful in identifying the nature and extent of cardiac damage are blood tests that measure the levels of various substances in the blood, including blood enzymes, such as troponin and creatine kinease; lipids, including cholesterol and triglycerides; C-reactive protein; and homocysteine.

    Treatment Options

    • Treatment for ischemic heart disease depends to a large extent on the degree of damage, if any, that has been done to the heart muscle. Modes of treatment include medication, lifestyle modifications and, in extreme cases, surgical intervention. If CHF has reached an advanced stage, your doctor may recommend the implantation of a device to give your heart an assist. Such devices include pacemakers, implantable cardioverter defibrillators and left ventricular assist devices.

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