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Advanced Ischemic Heart Disease

Advanced ischemic heart disease, also known as advanced coronary artery disease, includes conditions that reduce the blood flow to the heart, producing damage to the heart muscle. Damage to the heart muscle causes conditions such as cardiac arrhythmias (abnormal heartbeat), heart failure (poor heart function), and heart valve dysfunction (like mitral regurgitation).

What is Advanced Ischemic Heart Disease?

Advanced ischemic heart disease refers to a severe stage of coronary artery disease (CAD), a condition where the blood vessels supplying the heart muscle become narrowed or blocked. Ischemia occurs when the blood flow to the heart muscle is insufficient, usually due to the buildup of fatty deposits (plaque) in the coronary arteries.

In advanced stages, ischemic heart disease may lead to significant damage to the heart muscle, resulting in conditions such as myocardial infarction (heart attack) or chronic heart failure. The reduced blood flow and oxygen supply to the heart can cause chest pain (angina) and other symptoms, impacting the overall functioning of the heart.

Causes of Advanced Ischemic Heart Disease

Coronary Artery Disease (CAD): The primary cause of advanced ischemic heart disease is the progression of coronary artery disease. Over time, plaque accumulation on the coronary arteries' inner walls narrows or blocks these vessels, reducing blood flow to the heart muscle.

Atherosclerosis: The development of atherosclerosis, characterized by the buildup of cholesterol, fat, and other substances in the arteries, contributes to the narrowing of coronary vessels and exacerbates ischemic conditions.


Risk Factors: Certain risk factors, such as smoking, high blood pressure, high cholesterol levels, diabetes, and a sedentary lifestyle, increase the likelihood of developing advanced ischemic heart disease.

Treating Advanced Ischemic Heart Disease

Treatment for advanced ischemic heart disease may involve lifestyle changes, medications, interventions, and ongoing management to improve blood flow to the heart muscle and alleviate symptoms. Individuals with ischemic heart disease should work closely with healthcare professionals to develop a personalized treatment plan based on the severity of their condition. We routinely offer second opinions. Treatment options may include:

  • Complex Coronary Intervention with adjunctive procedures beyond stenting, often including Atherectomy (plaque modification), LASER, or Chronic total occlusion (CTO) angioplasty/stenting.
  • Supported High-Risk PCI, in which we use heart pumps to support blood pressure and perfusion during coronary intervention.

How Do I Know If I Have Advanced Coronary Disease?

Those with advanced coronary disease may experience one or more of the following factors:
  • You have had several angioplasty procedures and stents for recurrent, persistent coronary disease.
  • You have an occluded coronary artery that has been closed for some time, a chronic total occlusion (CTO), with persistent chest pain.
  • You may have had a coronary artery bypass surgery and require additional revascularization.
  • You may have been turned down for open heart surgery.
  • You are still experiencing symptoms even while you have been receiving traditional treatment for coronary artery disease.
  • You have been informed that there are no more treatment options for your coronary artery disease.
  • You have been advised that you are at greater risk of developing heart failure and arrhythmias.

Managing Advanced Ischemic Heart Disease

Our cardiovascular specialists are committed to diagnosing and treating patients with severe ischemic heart disease, especially when the best course of treatment is not apparent. In many cases, patients with ischemic heart disease have been informed they have exhausted conventional treatment options. We are here to help. Discover how we can help you enhance your heart health today.

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