Over the last seventy there is change in disease pattern in south east asian region. Ischemic heart disease (IHD) represents the leading cause of death in elderly [1]. Ischaemia means a reduced blood supply. The coronary arteries supply blood to the heart muscle and no alternative blood supply exists, so a blockage in the coronary arteries reduces the supply of blood to heart muscle. Most ischaemic heart disease is caused by atherosclerosis, usually present even when the artery lumens appear normal by angiography [2-4].

The presentation of ischemic heart disease varied from site to site and continent to continent. Presentation is different in male and females this is because of some biological factors, social, environmental, and community factors [5]. Mortality because of ischemic heart disease is increases with day passes. This was mainly because of unavailability of health facilities at rural levels and urban slums, Mode of transportation and communication is less and population explosion [4-8].An expanded view of the multifactorial epidemiology of IHD has identified important risk factors, including age, race, culture, ethnicity, and lifestyle influences that adversely impact cardiovascular outcomes.

Hypertension, diabetes mellitus, and smoking are more potent risk factors for MI in all age group. Key contributory factors to progression of atheromatous disease include smoking, hypertension, hyperlipidaemia, diabetes, and obesity [7-9]. Chest discomfort in the setting of exertion or emotional stress is the predominant clinical presentation of chronic stable angina. The typical presentation is exertional, or stress induced central chest pain. These episodes usually last from a few minutes to hours and can resolve upon rest. Common descriptions by the patient include tightness, crushing stabbing or burning pain. Patients may also have nausea and vomiting, dyspnoea, palpitations [10].

Typical symptoms increase the likelihood of an acute myocardial infarction (AMI) however atypical presentations cannot be used to exclude AMI. Women, the elderly and those with diabetes mellitus often present with atypical chest pain. Atypical presentations, including pain in the epigastrium, jaw, neck, or arms are also common, particularly in women, people with diabetes, and older people.

The patients were from age of 21 to 90 years. Most of patients were belong to age group of 51 to 60 years (32.5%) and 61 to 70 years (27.8%) (Table 1). The mean age of participants was 59.43±5.3 years. When differentiated in male and females, mean age of male patients was 58.57±7.2 and female patients was 63.14±4.6 years. Among all the patients 175 were male and 80 were females. Total 18 (7.05%) patients were died. Out of these 18 died patients, 12 were male and 6 were female (Figure 1).

Table-1: Distribution of Cases according to age Group

Figure- 1: Deaths in a different sex distribution.

Table-2: Distribution of Cases according Presenting Symptoms

This pain is mainly radiating toward Neck and jaw in 10.98% patients, Left arm in 13.33% patients and 6.66% in Epigastric area. (Table 4).

There were 150 patients (58.82%) had past history of hypertension, 99 (38.82%) had diabetes and 96 (37.64%) patients had history of ischemic heart disease. The family history is also an important factor for diagnosis. In this study 73 patients (28.62%) had family history of hypertension, 19 (7.45%) diabetes and 19 (7.45%) had family history of ischemic heart disease. But 115 (60.78%) patients did not have any family history. There were 102 patients had vegetarian diet and 153 patients were on non-vegetarian diet. 117 patients (45.88%) were had history of smoking and 97 patients (38.04%) had history of Alcohol intake (Table 5).

Epidemiological studies revealed that incidence and prevalence of Ischemic heart disease is increasing day by day and increase trend is seen in risk factor of these diseases. This study had a total of 255 patients with 170 male and 80 females. This study showed that 60.3% were in the age group of 51 to 70 years. Indians have one of the highest rates of heart disease in the world.

The disease also tends to be more aggressive and manifests at a younger age. 18 patients came to institute were died [13]. Women suffering from acute coronary syndrome or myocardial infarction are likely to be older: are more likely to have a history of hypertension, diabetes, unstable angina, hyperlipidemia, and congestive heart failure; and are less likely to be smokers than their somewhat higher than male counterpart [14-17].

Out of these 18, about 10 had complain of chest pain and rest 8 were without complain of chest pain they only complain of breathlessness and uneasiness. This finding is quite consistent with finding of other study stated that patients who experienced MI with chest pain had less likely to die than compared with patients with chest pain [18].

The main reason behind that was delay in seeking care and delay in receiving important therapy. In the present study chest pain was the most common presenting complaint followed by sweating and breathlessness. Presenting symptoms usually include chest pain with typical radiation, nausea and diaphoresis. Older patients less frequently have typical signs and symptoms such as chest pain with classical radiation pattern.

Acknowledgement: Author would like to thank to all staff working in my department for helping me in conduction of this study and also supporting me in each and every step.