Cardiac Ischemia and Society

Importance of Cardiac Ischemia

Ischemic heart disease is a leading cause of morbidity and mortality.

Myocardial ischemia: Imbalance between myocardial oxygen supply and demand. ACS often the first CVD manifestation.

Common: 2.7M affected in the UK.

Chronic disease with profound effects.

Preventable

Atherosclerotic Diseases

The prevention of coronary disease has improved since the 1970s.

The overall burden of CVDs remained high during 2000-19.

Stalling decline in coronary heart disease in younger age groups is of concern.

Cardiovascular Disease Deaths

Ischaemic heart disease is the leading cause of CVD mortality across males and females

Coronary Artery Disease Risk Factors

Modifiable:- Smoking - Overweight - Inactivity - Diabetes - High blood pressure - High cholesterol - Unhealthy diet

Unmodifiable:- Age - Gender - Ethnicity - Genetics

Clinical Presentation of Cardiac Ischemia

Cardiac ischemia: Decreased blood flow and oxygen to the heart muscle

Angina

Symptoms include fullness, burning, squeezing, and pressure. - Other Symptoms: Sweating, nausea, dizziness, shortness of breath, fatigue

Heart Attack

Signs: Sweating, nausea, shortness of breath, dizziness, fainting, chest pain.

ACS Spectrum

Ranges from asymptomatic to cardiac arrest.

Includes unstable angina, NSTEMI, and STEMI

.MINOCA

Patients present with ACS symptoms, troponin elevation, and non-obstructive coronary arteries

Long Term Treatment After ACS

Discharge on cardio-protective medications, start lifestyle management, and refer to cardiac rehab.

Support healthy lifestyle choices

Annual influenza vaccination

Optimal pharmacological and cardio-protective treatment

Costs of Cardiovascular Disease to the NHS and Wider Society

Estimated £15.8 billion per year - Healthcare costs alone in England stand at an estimated £7.4 billion per year

NHS Health Check

Assess the top 7 risk factors driving premature death and disability in England among 15 million people in midlife.