Criteria for ischemic cardiomyopathy:
(1) severe, diffuse left ventricular dysfunction
(2) presence of severe coronary artery disease
(3) exclusion of other causes of cardiomyopathy
Left ventricular dysfunction is manifested by:
(1) a decrease in the left ventricular ejection fraction (<= 35%)
(2) diffuse hypokinesis on imaging studies
(3) diffuse nonviability on imaging studies
(4) elevated pressures in the pulmonary artery
Clinical findings include:
(1) Most patients have a dilated heart.
(2) Most patients have congestive heart failure with dyspnea.
(3) Most patients have a history of multiple myocardial infarctions, although a few patients do not have a history of any.
(4) Most patients have angina.
(5) Loss of myocardial function may occasionally be reversible with time, which has given rise to the concept of transient dysfunction by "stunned" or "hibernating" myocytes.
(6) Infarction involving the papillary muscles can result in mitral regurgitation.
(7) Some patients may develop a left ventricular aneurysmal dilatation.
