Ischemic Heart Disease

Your Care Explained > Conditions and Diagnoses : Ischemic Heart Disease

Ischemic heart disease (IHD) can result from two conditions—coronary artery disease and microvascular disease—that reduce blood flow to the heart muscle.

In women, ischemic disease is more likely to be due to microvascular disease, which produces different symptoms from those of coronary artery disease. As a result, ischemic heart disease in women may require different diagnostic tests, such as catheterization pressure/flow studies and intravascular ultrasound (IVUS), to identify the source.

Symptoms of IHD

When IHD is caused by coronary artery disease, the most common symptoms are a pressing, squeezing or crushing pain, usually in the chest under the breastbone, but may also occur in the upper back, both arms, neck or earlobes; pain radiating in the arms, shoulders, jaw, neck and/or back; shortness of breath; cold sweat; and nausea. When it is due to microvascular disease, symptoms may be less dramatic and may include diffuse discomfort, exhaustion and depression.

Diagnosing IHD

In addition to a complete medical history and medical examination, a physician can often diagnose ischemic heart disease by noting the patient’s symptoms and how and when they occur. Certain diagnostic procedures, including electrocardiography, echocardiography and cardiac catheterization with IVUS, may be performed.

Treating IHD

If the symptoms are found to be due to an ischemic artery obstruction, they may be treated with procedures to remove the blockage, such as coronary artery bypass surgery or angioplasty. If they are due to microvascular disease, lifestyle modifications—diet, exercise, smoking cessation—and medications to lower blood pressure, improve lipid profile and reduce inflammation may be prescribed. Since ischemic heart disease is a chronic condition, your heart will be carefully monitored and you will be prescribed medications to control your symptoms.

Nutrition and Prevention

Reference these links for information on how to prevent heart disease and how to live a healthy lifestyle.

Date Last Modified: January 21, 2011

Send Feedback To: BWH Women’s Health at

75 Francis Street, Boston, MA 02115 617.732.5500
harvard medical school partners healthcare © BWH 2011