Ischemic Heart Disease

Ischemic heart disease (IHD) refers to a group of clinical syndromes characterised by myocardial ischemia, or an imbalance in the supply and demand for myocardial blood. Because the fundamental pathophysiologic defect in the ischemic myocardium is insufficient perfusion, ischemia is associated not only with insufficient oxygen supply, but also with decreased nutrient availability and insufficient removal of metabolic endproducts. The effects of oxygen deprivation cannot be separated from the effects of impaired metabolite washout in myocardial ischemia. The deleterious consequences to the myocardium are generally less prominent in conditions associated with isolated hypoxemia and preserved perfusion (such as cyanotic congenital heart disease, severe anaemia, or advanced lung disease), emphasising the importance of metabolite removal and supply with metabolic substrates in the pathogenesis of ischemic injury.


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