Ischemic heart disease is the leading cause of death in the Western world.

There is a greater prevalence of ischemic heart disease in men, which is responsible for approximately 40 per cent of all deaths in males who are still of working age.

Ischemic heart disease (coronary heart disease, coronary artery disease) is a medical disorder in which the heart is not able to pump sufficient blood to meet the metabolic requirements of the body, due to reduced circulation in the heart.

In ischemic heart disease an imbalance therefore arises between oxygen supply and demand.

The heart receives its own supply of blood from the coronary arteries. There are two main coronary arteries which branch directly from the aorta and then subdivide into arterioles and ensure blood circulation to the heart.

The term ischemia means reduced blood flow to an area of an organ or the entire organ.

The reduced circulation, deficiency or ischemia which develops in this condition arises because of changes within the intima or inner walls of the arteries due to the adverse effects of atherosclerosis.

This results in narrowing of the arteries and reduced flow of blood to the heart and explains the origin of the terms 'coronary heart disease', 'coronary artery disease' which are synonyms for and used inter changeably with ischemic heart diseases.

It must also be clarified here that the term 'angina' is often used loosely and incorrectly to refer to ischemic heart disease in general. But angina pectoris (which literally translates as chest wall pain) is actually a typical manifestation of coronary heart disease.

Attacks of angina are usually precipitated by physical exertion or emotional upset, although in the severe cases of coronary heart diseases can even occur at rest.

During an attack of angina the patient usually complains of the sudden onset of chest pain which is usually located to the left or behind the sternum.

It’s described as a sharp squeezing or pressing sensation in the chest which is accompanied by difficulty or discomfort in breathing.

The pain of angina typically radiates or spread upwards to the lower jaw or along the left arm resulting in a cramp like sensation in the limb.

The severity of the pain typically forces the patient to stop whatever he or she was doing, which usually results in relief or lessening of the pain.

Attacks of angina are typically relieved by tablets which are placed under the tongue. The effect of these is to produce rapid dilatation of the coronary blood vessels, although the effect lasts for a fairly short time.

It is of utmost importance for all persons who are diagnosed with coronary heart to always bear in mind that: Chest pain or any attacks of angina which is not relieved or reduced by the tablets normally placed under the tongue could be a warning sign of a heart attack (myocardial infarction)!Immediate medical attention must be sought!

It is also critical to highlight here that heart attacks which occur at the base of the heart may present with typical dyspeptic symptoms of upper abdominal pain (or discomfort), nausea and vomiting.

These typical symptoms and signs of indigestion during an impending heart attack is, often times, a peculiar presentation of heart attacks which occur in middle aged women.

It is therefore very important for all middle-aged women to bear in mind that any unusual or sudden onset of upper abdominal or stomach discomfort may actually be a heart attack occurring. This is independent of the fact whether they had been previously diagnosed with ischemic heart disease or not.

Ischemic heart disease results in very high morbidity and mortality. An understanding of the risk factors and efforts aimed at reducing and eliminating them, where possible, is a very important step to reduce the incidence of the disease and premature deaths from this condition.

The risk factors for ischemic heart disease are divided into two broad groups, the irreversible and reversible risk factors.

The irreversible risk factors are those factors which are not within our control, for example genetic factors.

The reversible risk factors are within our control, lifestyle dependent and can be reduced through the appropriate lifestyle modifications.

Irreversible risk factors for ischemic heart diseases include:

1. Male sex, there is a much higher prevalence in men 2. Genetic predisposition, that is a strong family history predisposes one 3. Age, the likelihood of the disease increases as we get older.

Reversible risk factors for ischemic heart disease include:

1. Sedentary lifestyle 2. High blood pressure (hypertension) 3. High cholesterol (hyperlipidemia) 4. High blood sugar (Diabetes) 5. Obesity 6. Smoking 7. Alcohol abuse

There is no doubt that regular exercises and physical activities are good for our general health and well -being. Quite often the overall health benefits are even underestimated.

Exercises burn excess calories, reduces the chances of obesity, improves and strengthen muscles tones, (including the muscles of the heart) dilate blood vessels resulting in improved circulation and metabolism and lower both blood pressure and cholesterol.

Regular exercises and increased levels of physical activities along with a balanced diet and the right amount of rest and relaxation to reduce stress levels have been shown to lessen significantly, the chances of developing many chronic medical diseases, like high blood pressure, diabetes and ischemic heart disease.