Ischemic Heart Disease: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Ischemic Heart Disease?
A cardiologist, a doctor who treats heart disease, usually treats ischemic heart disease. A primary care doctor often helps with risk factors like blood pressure and cholesterol. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is ischemic heart disease?
Ischemic heart disease is another name for coronary artery disease. The coronary arteries are the blood vessels that carry blood and oxygen to your heart muscle. When these arteries are damaged or diseased, your heart does not get the blood it needs. It is the most common type of heart disease in the United States.
Coronary microvascular disease affects the heart's tiny blood vessels and is more common in women.
Symptoms
Symptoms vary from person to person. Some people have no symptoms at all. When symptoms do occur, they may include:
- Chest pain, pressure, tightness, or discomfort that may spread to your neck, jaw, shoulder, or arm.
- Shortness of breath.
- Feeling unusually tired.
These symptoms may start or get worse when you are active or under stress and may go away with rest. Angina is chest pain or discomfort caused by reduced blood flow to your heart. Some people do not know they have it until a heart attack or cardiac arrest, when the heart suddenly stops beating. Over time, it can lead to heart failure. This means the heart cannot pump enough blood for the body's needs.
Causes and who gets it
The disease develops slowly over time when plaque builds up inside your coronary arteries. Plaque is a waxy, sticky substance made of fat, cholesterol, calcium, and other things in your blood. This buildup is called atherosclerosis. As plaque grows, it narrows the arteries and reduces blood flow to your heart muscle. You may be more likely to have it if you:
- Eat a diet high in saturated fat.
- Smoke or use tobacco products.
- Are not physically active.
- Are overweight or have obesity.
- Have high blood pressure, high cholesterol, or high blood glucose (diabetes).
- Have a family history of heart disease, especially a parent or sibling who had it before age 50.
- Are getting older. Men tend to develop it earlier in life than women.
How doctors diagnose it
Your provider may ask about your symptoms and your personal and family health history. They may review your risk factors and lifestyle habits and do a physical exam, including checking your blood pressure. They may order blood tests, including checking your cholesterol and blood glucose. Heart tests can include:
- An electrocardiogram, which measures the electrical activity, rate, and regularity of your heartbeat.
- An echocardiogram, which uses ultrasound to create a picture of the heart.
- An exercise stress test, which measures your heart rate while you walk on a treadmill.
- A chest X-ray, which creates a picture of the heart, lungs, and other organs in the chest.
- A coronary angiogram, which uses X-rays to detect dye injected into the heart's arteries through a thin tube.
- A coronary artery calcium scan, a CT scan that looks for calcium buildup and plaque in the coronary arteries.
Treatment
Your provider plans treatment based on which arteries are affected, how much blood flow is blocked, and your other health conditions. Treatment may include:
- Heart-healthy lifestyle changes, such as eating a heart-healthy diet, being more active, and quitting smoking.
- Medicines to lower blood pressure, reduce cholesterol, control blood glucose, or prevent blood clots.
- Procedures or surgery, such as angioplasty or coronary artery bypass grafting, to open or bypass blocked arteries.
- Cardiac rehabilitation, a supervised program of physical activity and education.
Cardiac rehabilitation can help improve your quality of life and help prevent future heart problems.
When to see a doctor
Call 911 right away if you have chest pain or discomfort that lasts two minutes or more or happens while you are resting, trouble breathing, or fainting. These may be signs of a heart attack. Other signs are weakness, light-headedness, nausea, a cold sweat, and pain or discomfort in the arms or shoulder. Do not drive yourself.
See a doctor if you feel more tired than usual when you are active. Also see one if you have high blood pressure, high cholesterol, diabetes, or heart disease in your family.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can measure your blood pressure, cholesterol, and blood sugar to help check your risk. They can also help you keep up with your care plan and refer you to a heart specialist.
Common questions
Is ischemic heart disease the same as coronary artery disease?
Yes, they are two names for the same condition. It is also called coronary heart disease.
Can you have ischemic heart disease without symptoms?
Yes, some people have no symptoms at all. Others do not know they have it until they have a heart attack.
What should I do if I have chest pain?
Call 911 if chest pain or discomfort lasts two minutes or more or happens while you are resting. It may be a sign of a heart attack.
Can ischemic heart disease be prevented?
For most people, it can be prevented with a heart-healthy lifestyle and medicines. Helpful steps include eating heart-healthy foods, being active, reaching a healthy weight, and not smoking. Limiting alcohol, managing stress, and getting enough good sleep also help.
Sources
- MedlinePlus - Coronary Artery Disease
- Centers for Disease Control and Prevention - About Coronary Artery Disease (CAD)
- National Heart, Lung, and Blood Institute - What Is Coronary Heart Disease?
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
