Ischemic Cardiomyopathy

Its cause is specifically myocardial ischemia due to coronary artery disease (usually from IHD or a prior infarction). Non-ischemic cardiomyopathies develop from other causes unrelated to narrowing of the heart's vessels.

Inadequate blood supply to the myocardium due to significant coronary artery narrowing, a prior myocardial infarction, and previously performed stenting or bypass surgery.

Shortness of breath that worsens over time, weakness on exertion, swelling of the ankles and lower legs, chest pain or discomfort, a cough unrelated to a cold, heaviness in the right upper abdomen, and an irregular heartbeat.

Without treatment it progresses quickly, leading to severe heart failure, rhythm disturbances, disability, and an increased risk of a poor outcome. That is why starting treatment as early as possible matters.

It starts with a cardiologist consultation, an ECG, echocardiography (assessing ejection fraction and heart size) and a chest X-ray. When indicated, an exercise stress test and coronary angiography are performed to identify coronary artery disease.

Ejection fraction shows what proportion of blood the heart pumps out with each contraction. Normally it is about 55–65%. In ischemic cardiomyopathy it is often reduced, and its value helps assess disease severity and guide treatment.

Treatment is comprehensive: medication therapy for heart failure and IHD, risk-factor control, and — for significant arterial disease — restoring blood flow with stenting or coronary artery bypass grafting. The strategy is determined individually by the physician.

Already-damaged myocardium cannot be fully restored, but timely treatment and, when needed, surgery can halt progression, reduce symptoms, and improve quality and length of life.

With its natural course, the prognosis is unfavorable. However, quality diagnosis, well-chosen treatment, and timely intervention substantially improve the prognosis and extend life. The exact prognosis depends on the extent of disease and is determined by the physician.

Restoring blood flow is indicated for significant coronary artery narrowing. The choice between stenting and coronary artery bypass grafting depends on the nature of the disease and the patient's condition; the heart team decides based on coronary angiography results.

With severe heart failure and reduced ability to work, disability status may be granted. This is decided individually based on examination results and physicians' conclusions.

It is important to regularly take prescribed medications, control blood pressure, cholesterol and blood sugar, quit smoking, maintain manageable physical activity, and stay under a cardiologist's follow-up.

Yes. Diagnosis and treatment at Pirogov Clinic are available under Compulsory Health Insurance (CHI) and federal quotas when indications and a referral are in place. Our administrators will help with the paperwork.

A cardiologist. If surgical treatment is needed, cardiovascular surgeons and endovascular specialists join the care team.