Congestive Cardiomyopathy

Congestive cardiomyopathy is a clinical state in which an abnormality of ventricular myocardium results in impaired pump function and circulatory congestion. Multiple factors have been incriminated in the etiology and progression of the myocardial damage. Unfortunately, therapy aimed at elimination or control of these etiologic factors has, for the most part, been unsuccessful in the restoration of normal muscle function. Because of the high prevalence of ischemic heart disease in the United States, it is convenient to classify the cardiomyopathies into two groups: ischemic and nonischemic (Table). Left ventricular failure owing to ischemic heart disease is usually indicative of extensive coronary vascular disease, and the prognosis is poor.1Surgical resection of an aneurysm or reperfusion of an ischemic area with coronary artery bypass surgery may improve ventricular function, but future progression of the disease probably is not halted. Examination of the Table reveals that a similar situation exists with