Background
- IHD (aka coronary heart disease, coronary artery disease) is the presence of symptoms or signs of cardiac ischaemia.
- The commonest ischaemia cause is atherosclerosis, the formation of lipid-laden plaques in coronary artery walls.
- Symptoms occur when plaques (a) grow and obstruct the vessel, causing angina, or (b) rupture and form a thrombus, occluding the vessel and causing an acute coronary syndrome.
Presentation
IHD can present with angina or acute coronary syndrome (ACS).
Risk factors
Modifiable RFs:
- HTN
- Dyslipidaemia: ↑ TC, ↑ TC:HDL ratio, ↑ LDL.
- Diabetes
- Smoking
- Excess alcohol
- Obesity
Fixed RFs:
- Age
- Male
- South Asian ethnicity.
- Medical history of atheroma: MI, stroke, or PVD.
- Family history: MI in 1st-degree relative, male < 55 years, female < 65 years.