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Ischemic heart disease; Cardiomyopathy - ischemic
Patients with this condition often have had symptoms of angina or a heart attack. Sometimes, patients do not notice any symptoms.
Symptoms of heart failure usually develop slowly over time. Common symptoms include:
The physical exam may be normal, or there may be signs that fluid is building up in the body:
There may be other signs of heart failure.
This condition is usually diagnosed if a test shows that the heart is not pumping as well as it should. This is called a decreased ejection fraction. A normal ejection fraction is around 55 - 65%. Many patients with this disorder have ejection fractions much less than this.
People with ischemic heart disease can have the symptoms and signs of ischemic cardiomyopathy even when their ejection fraction is normal or near normal. This is because the heart does not fully relax (impaired filling). It is sometimes called "diastolic heart failure" or "heart failure with preserved ejection fraction."
Tests used to measure ejection fraction include:
Biopsy of the heart is needed in rare cases to rule out other conditions.
Morrow DA, Boden WE. Stable ischemic heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa; Saunders Elsevier;2011:chap 57.
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