Nearly all of us in today’s world have heard these terms as heart attack is one of the most dreaded killers of our age. But what these individual terms mean, what leads to what and how is managing your lifestyle going to help? Read below to understand these terms and their interrelations fully

Ischemic Heart Disease or Coronary Heart Disease (IHD or CHD) is part of a spectrum of diseases, called AtheroSclerotic CardioVascular Diseases (ASCVD).  ASCVD affects the heart and blood vessels, especially arteries and leads to ‘clogging of arteries’. Read below a more detailed description:

Basics of heart (cardiac) , blood vessels (vascular) and circulation

We know that the blood that runs continuously in our body is pumped by heart and purified or oxygenated by our lungs.

Arteries and veins are the two types of big blood vessels in our body. Pure or oxygenated blood flows in arteries and deoxygenated blood produced by our organs is taken up and taken back to heart and then lungs by veins.  Between arteries and veins there are smaller vessels called arterioles, venules etc. which are like small tributaries to these rivers. Our blood carries the glucose, cholesterol, amino acids and fatty acids derived from food that we eat

What is  Cardio Vasular Disease (CVD) and AtheroSclerosis?

  • Atherosclerosis is a disease of arteries, in which plaques or small bumps (made up of  cholesterol, fat and other substances) form in the arteries. If the blood LDL cholesterol levels are high, there is more cholesterol and fatty substances available for plaque formation.
  • These plaques invoke the body’s inflammatory response in the blood vessel and thus calcium deposition happens in these bumps, making them harder than they should be
  • The blood flow through an area of plaque containing artery becomes turbulent and more inflammatory response leads to the plaque getting bigger, until it becomes so big that the blood flow to the organ supplied by the artery becomes reduced
  • This is how atherosclerosis leads to CVD or CardioVascular Disease. You may be wondering why the word ‘cardio’ (means heart) is there! That is because the coronary arteries which supply blood to the heart itself are most commonly involved in atherosclerosis

Atherosclerosis also commonly affects arteries supplying the brain, kidneys and legs. All in all, a love of vital organs this condition has !

Cardiovascular disease includes:

  • Coronary Heart Disease (CHD) or Ischemic Heart Disease (IHD): blood vessels of heart are narrowed and this may lead to chest pain (angina) or heart attack (Myocardial Infarction) etc.
  • Carotid Artery disease (CAD): blood vessels of the brain are affected, can lead to neurological problem causing temporary symptoms (TIAs /Transient Ischemic attacks) or stroke
  • Peripheral Artery Disease (PAD): blood vessels of limbs are affected, especially those of leg and feet, which can lead to pain on walking or at rest, ulcer or even gangrene
  • Chronic Kidney Disease(CKD): blood vessels of kidney are affected, can lead to compromise of kidney functions and even kidney failure

Commonest sudden and catastrophic complications of CVD are heart attack and stroke (sometimes called brain attack), both of these result in one of the  two ways:

  1. The lumen of the vessels supplying some part of brain or heart get gradually narrowed such that enough blood is not able to reach these organs. In these cases, usually, warning signs of CVD are there. It is important to know and pay heed to these symptoms and get them evaluated, especially if you know you have risk factors for heart disease/CVD
  2. There is sudden rupture of  plaque leading to blockage of the vessel and heart attack or stroke may result, sometimes not preceded by any other symptoms, therefore it is important to get a heart risk assessment done, so that you can be timely alerted about your risks and can manage them

So what are the warning signs and symptoms of heart attack and other CVDs?

Ischemic Heart Disease

  • Angina: chest pain which may feel heavy or like someone is squeezing your heart.
    • You may feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back. The pain usually occurs with activity or emotion, and goes away with rest
    • If it comes with some bit of effort, more or less consistently, it would most likely be stable angina, it the pain comes at increasingly smaller effort or at home and last for more than 10-20 minutes, it could be unstable angina, a more serious condition
    • However, not all chest pains are angina, in fact in a primary care setting the majority are not, but you are better off getting angina ruled out, especially if your risk for heart attack is high
  • An anginal equivalent is a symptom such as shortness of breath , cold sweat, extreme fatigue, or pain at a site other than the chest,  nausea, vomiting, lightheadedness, which could be due to CVD
  • Upper body discomfort could also be a symptom of heart disease; you may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button).The discomfort usually lasts more than a few minutes or goes away and comes back. . It also can feel like heartburn or indigestion.

Heart attack: The pain in heart attack is similar to angina, but it lasts longer and your doctor will confirm it with tests (ECG and enzyme assays). Any angina or angina equivalent symptoms which occur suddenly in a person with high risk of heart attack, is to be treated as a potential heart attack, it is best to seek medical care!

Carotid Artery Disease

TIA (Transient Ischemic Attack): It means that the blood supply to the brain is compromised for some time but recovers within 24 hours; usually the time to recovery is just a few minutes. The symptoms could include any of the following:

  • Sudden loss of consciousness,
  • Sudden blurring, dimming or loss of vision in one or both eyes,
  • Sudden speech difficulty,
  • Loss/weakening  of movement in limbs or face,
  • Numbness in a part of the body,
  • Tingling around mouth,
  • Change or decline in alertness, mental function or behaviour noted by people close to you

Stroke: It is an emergency in which there is prolonged compromise to blood supply of the brain. The symptoms are similar to those of TIA, but last longer. Any TIA attack is best treated as a stroke and you must seek medical care urgently

PAD (Peripheral Arterial Disease)

It means that the blood supply to the peripheral arteries (those of limbs, especially legs) is compromised. The symptoms could include:

  • Pain in the instep or calf on walking a certain distance, which gets relieved on rest or
  • Unusually cold feet
  • Weak or absent pulses in the legs or feet
  • Sores or wounds on the toes, feet, or legs that heal slowly, or not at all AND
  • Erectile dysfunction

CKD (Chronic Kidney Disease)

High blood pressure and diabetes are both common causes of chronic kidney disease, which remains silent for a long time and when signs and symptoms occur they are in the form of

  • Microscopic hematuria (presence of blood cells in urine detected in urine test)
  • Swelling of face and feet, especially in the morning
  • Kidney failure

Being proactive for heart health

While it is good to know about the symptoms of heart disease, so that you reach out for medical care early, by that time, the disease is well established and has already cause a lot of damage. It is best if one focuses on the risk factors for CVD/ heart disease and keeps them under control, so that the disease never develops or it controlled early

To know about heart risk factors and how to manage them, read our posts in ‘Know heart risk factors‘, ‘Assess your heart risk‘ and ‘Manage your heart risk‘ segments

Another important way to manage your risk is to get routine health check up done AND analyzed for heart health and overall wellbeing. Check out FHI Health checklist for adults and FHI health check analysis


CHECK OUT: Our references for recommendation in heart risk management