ischemic cardiomyopathy

If a region of muscle is repeatedly starved of blood, it eventually weakens — like a field that fails to grow when its irrigation channels keep clogging. Ischemic cardiomyopathy is heart-muscle weakness and enlargement caused by chronic coronary artery disease: narrowed or blocked coronary arteries deprive the muscle of oxygen, and over time, often after one or more heart attacks, the pump fails.

Mechanistically, dead muscle from prior infarction is replaced by non-contracting scar, while other regions, chronically short of blood, contract sluggishly (sometimes called hibernating myocardium that may improve if blood flow is restored). The ventricle dilates and its ejection fraction falls, producing heart failure that looks much like dilated cardiomyopathy — but here the root cause is the coronary arteries.

Distinguishing it matters because the treatment differs: in addition to standard heart-failure therapy, restoring blood flow with stents or bypass surgery can help selected patients, and aggressive control of risk factors is central. Strictly, the classical definition of cardiomyopathy excluded coronary disease, so the term is something of a useful clinical extension rather than a pure match to the original meaning.