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Chronic Ischemic Cardiomyopathy

Left ventricular dysfunction from long-standing coronary artery disease, producing a broad heart failure syndrome.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Chronic Ischemic Cardiomyopathy?

Chronic ischemic cardiomyopathy is the progressive decline in left ventricular systolic function caused by long-standing ischemia and/or prior myocardial infarctions related to coronary artery disease. It is the most common cause of heart failure and ejection fraction usually falls below 35–40%.

Pathogenesis involves acute ischemia, stunning, hibernation, fibrosis, dilation and adverse remodeling. The left ventricle may show segmental (infarct-related) or global hypokinesia, dilation and mitral regurgitation. Ventricular arrhythmia and sudden cardiac death risk are elevated.

Diagnosis is based on echocardiography, cardiac MRI (for viability assessment) and coronary angiography. Treatment includes standard heart failure therapies (ACE/ARB/ARNI, beta-blocker, MRA, SGLT2 inhibitor, diuretic) together with revascularization (PCI or CABG), CRT and ICD implantation when indicated.

Symptoms

Exertional dyspnea
Orthopnea and paroxysmal nocturnal dyspnea
Fatigue
Leg edema
Palpitations
Chest pain if active ischemia is present
Syncope

Risk Factors

Coronary artery disease
Prior myocardial infarction
Diabetes mellitus
Hypertension
Dyslipidemia
Smoking
Family history of early heart disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New heart failure symptoms in known CAD
  • Progressive dyspnea
  • Edema and weight gain
  • Unexplained fatigue
  • New palpitations
  • Syncope or presyncope

Treatment Methods

01
Heart failure medical therapy (ACE/ARNI, beta-blocker, MRA, SGLT2)
02
Revascularization (PCI or CABG)
03
Diuretic therapy
04
ICD implantation for EF <35%
05
CRT in suitable patients with wide QRS
06
Cardiac rehabilitation
07
LVAD or heart transplantation in advanced disease

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Related Health Topics

Other articles from the same department you may want to explore.

Hypertension (High Blood Pressure)

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Hypertension is a condition in which blood pressure readings remain above 140/90 mmHg; early treatment helps prevent serious complications.

Coronary Artery Disease

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Narrowing of the coronary arteries due to atherosclerosis can cause chest pain (angina) and heart attack.

Heart Failure

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Heart failure is a chronic cardiac condition characterized by shortness of breath, leg swelling, and fatigue.

Heart Attack (Myocardial Infarction)

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A heart attack is a medical emergency; because heart muscle is lost by the minute, immediate intervention saves lives.

Atrial Fibrillation

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Atrial fibrillation is a common arrhythmia characterized by an irregular heartbeat and increased risk of stroke.

Heart Palpitations

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Palpitations are usually due to benign causes, but underlying cardiac rhythm disorders must be ruled out.

Heart Valve Diseases

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Valve stenosis or regurgitation increases the workload of the heart and, over time, can lead to heart failure.

Aortic Aneurysm

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Aortic aneurysms are often silent; early diagnosis allows treatment before rupture (a life-threatening tear).

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.