Ischemic Cardiomyopathy
Disease Description
Ischemic cardiomyopathy is a form of chronic ischemic heart disease. It is characterized by significant dilation of the cardiac chambers and a reduction in the heart’s pumping function.
Causes of the Disease
Ischemic cardiomyopathy is caused by inadequate myocardial perfusion and insufficient oxygen delivery due to impaired blood flow through the coronary arteries.
When the diagnosis is established, the ischemic cause is clearly identified and may include severe narrowing of the coronary arteries, a history of myocardial infarction, or previous coronary artery bypass grafting (CABG) or coronary stenting.
As a result, the heart muscle shifts into an energy-saving mode, deliberately reducing its metabolic demand and, consequently, the strength of cardiac contractions.
Symptoms
In addition to the typical symptoms of coronary artery disease — such as chest discomfort or angina — patients may experience progressively worsening shortness of breath, a persistent cough not associated with respiratory infection, weakness during usual physical activity, swelling of the ankles and lower legs, and a feeling of heaviness or dull pain in the right upper abdomen due to liver enlargement caused by congestion.
Cardiac rhythm disturbances and irregular heartbeats are also common.
The appearance of these symptoms is a clear reason to consult a cardiologist and undergo evaluation.
Diagnosis
When the above symptoms occur, it is essential to consult a cardiologist as soon as possible. A detailed consultation helps clarify symptoms, identify triggering factors, and determine cardiovascular risk factors — some of which can be reduced through medication or lifestyle changes.
A chest X-ray may reveal enlargement of the heart.
Electrocardiography (ECG) can detect signs of prior myocardial infarction and identify ischemic changes or myocardial hypertrophy.
Echocardiography (EchoCG) allows assessment of cardiac pumping function, chamber size, and wall thickness.
A positive exercise stress test is an indication for coronary angiography, which identifies the underlying cause of the disease — atherosclerotic plaques impairing myocardial blood supply.
Treatment
When symptoms of ischemic cardiomyopathy appear, early consultation with a cardiologist is essential. A thorough evaluation allows clarification of symptoms, assessment of risk factors, and selection of an individualized treatment strategy, including medication therapy and lifestyle modification.
Chest X-ray imaging may suggest cardiac enlargement, while ECG and echocardiography help assess myocardial damage, ischemia, hypertrophy, and impaired pumping function.
A positive exercise stress test serves as an indication for coronary angiography, which identifies the atherosclerotic lesions responsible for reduced myocardial perfusion and guides decisions regarding revascularization.
Treatment Prognosis
With the natural progression of the disease, the prognosis is unfavorable. After symptoms appear, ischemic cardiomyopathy often progresses rapidly, leading to disability and a high mortality rate.
Timely cardiology intervention, high-quality diagnostic evaluation, a well-designed treatment program, and — when indicated — prompt surgical treatment can significantly prolong life and relieve symptoms.