The Myocardium After Repeated Infarction

Dash et al¹,²have described a cardiomyopathic syndrome due to coronary artery disease as a separate disease entity. The description was published in two sequences, part al¹,²describing the relation of the syndrome to the extent of angiographically proved coronary disease and to remote myocardial infarction, and part 2 presenting the increased prevalence of this syndrome in patients with diabetes mellitus. Dash et al indicate that cardiomyopathic syndrome is specifically related to the decreased blood flow in the proximal coronary artery segments and to previous multiple myocardial infarcts. They present several distinguishing characteristics that make this cardiomyopathic syndrome different from cardiomyopathy owing to several other causes of chronic heart failure. Naturally, coronary heart disease always leads to decreased myocardial perfusion in some areas of the heart muscle. Arteriosclerotic changes, plaques, and calcifications do make the lumen of the coronary arteries smaller, and less blood is supplied to certain areas