Echocardiographic Assessment of Patient with Ischemic versus non-ischemic Dilated Cardiomyopathy (original) (raw)

Ischemic and non-ischemic cardiomyopathy (ICM and NICM) both cause heart failure, but the different etiologies may result in differences in management and outcome. Multiple trails and epidemiologic surveys have demonstrated that patients with ICM have decreased survival compared to patients with non-ischemic dilated cardiomyopathy (NIDCM). Increased age, multivessel arteriopathy, potent neurohormonal stimulation and arrhythmias associated with sudden death predispose patients with ICM to greater morbidity and mortality compared to patients with NIDCM. 1 Discussion: LV may be enlarged and show dysfunctional in both ischemic heart disease and dilated cardiomyopathy (DCM). Patients with ICM may benefit from a revascularization treatment strategy. 2 In clinical practice distinguishing between two types of conditions can be very challenging. In some situations, a diagnosis can be inferred from history and physical examination(e.g. Postpartum or chemotherapy induced NICM).Definition of ICM requires the identification of significant coronary artery disease (stenosis of any epicardial vessels more than 75%) or a history of myocardial infarction or previous revascularization of the coronaries in the presence of depressed LV ejection fraction (LVEF<45%). 3