Department of cardiac muscle pathology and transplantation of organs and tissues

cardiac ischemia

Ischemic heart disease: causes, symptoms, diagnosis and treatment.

Ischemic heart disease implies a pathological condition, where the need in energy resources for myocardium does not correspond to their expenditure. The cause of this is the coronary blood flow impairment.


Atherosclerotic lesion of the coronary arteries is the basis for the development of IHD. Alteration of the vessel intima, platelet aggregation at the site of the lesion and calcification of the microthrombus with simultaneous cholesterol deposition is the mechanism of atherosclerotic plaque formation. Thrombosis, embolism and spastic narrowing of the vessels also play an important role in the development of IHD.
Risk factors:

  • constitutional (hereditary predisposition, congenital malformations, male sex, age);
  • endogenous (obesity, hypertension, diabetes mellitus);
  • exogenous (bad habits, passive lifestyle, diet, polluted environment).


IHD is a collective name that unites a number of clinical forms: angina and its varieties, myocardial infarction, sudden coronary death, cardiosclerosis, arrhythmia.
It is clinically characterized by anginal pain syndrome, (associated or not related to physical and / or mental stress) with fear of death, dyspnea, tachycardia. In some cases, irregular heartbeat occurs, heart failure events develop (like legs swelling, cough, moist rales in the lungs, hepatomegaly).


IHD diagnosis can be established on the basis of complaints, anamnesis data and examinations:

  • ECG;
  • Echocardiography, transesophageal electrocardiography;
  • Laboratory diagnostics (creatinine, creatine kinaze, LDH1, cholesterol, lipoproteins and their fractions, atherogenicity coefficient);
  • Coronary angiography;
  • Holter monitoring;
  • Functional tests to determine the form and severity of IHD.


In the treatment of coronary heart disease, correction of diet and lifestyle with restriction of physical activity is used. ABS-therapy ("A" antiaggregants, "B" beta-blockers, "S" statins and fibrates - for lowering of cholesterol) is accepted as the world standard of medical treatment of ischemic heart disease. Depending on the form of IHD, treatment may include antiarrhythmic drugs, diuretics, nitrates, ACE inhibitors, metabolic therapy.
Surgical treatment includes aortocoronary shunting with autotransplant. More common and safe is minimally invasive endovascular balloon dilatation and stenting of the coronary vessels.



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