Clinical, Electrocardiographic, and Echocardiographic Profile of Ischemic Cardiomyopathy: An Analysis of 100 Cases

Background: Ischemic cardiomyopathy (ICM) remains a major contributor to the heart failure burden worldwide, characterized by significant morbidity and mortality. In Bangladesh, where cardiovascular disease prevalence is rising, understanding the local clinical profile of ICM patients is crucial for optimizing management strategies. Objective: This study aimed to analyze the clinical, electrocardiographic, and echocardiographic characteristics of ischemic cardiomyopathy patients. Methods: A retrospective cross-sectional study was conducted at Community Based Medical College Bangladesh, from January 2023 to December 2024. Using purposive sampling, we enrolled 100 consecutive ICM patients. Data on demographics, risk factors, clinical presentation, NYHA functional class, ECG findings, and echocardiographic parameters were collected and analyzed using MS Office. Results: The cohort had a mean age of 58.2±12.4 years with male predominance (68%). Major comorbidities included hypertension (62%) and diabetes (58%). Most patients presented with paroxysmal nocturnal dyspnea (84%) and pedal edema (62%), with 48% in NYHA Class III. ECG abnormalities included pathological Q waves (72%) and LBBB (32%). Echocardiography revealed a mean LVEF of 32.5±6.8%, with severe dysfunction (LVEF≤30%) in 36%. Anterior wall hypokinesia (54%) and moderate mitral regurgitation (68%) were common. Anterior MI (58%) showed worse LV function (30.2±5.6%) than inferior MI (35.1±7.2%). Conclusion: This Bangladeshi ICM cohort demonstrated advanced disease presentation with high rates of conduction abnormalities and ventricular dysfunction. The strong association of anterior MI with worse systolic function highlights the need for targeted management approaches in this population.