An ischemic cardiomyopathy is a chronic disorder caused by a lack of oxygen-rich blood flowing to the heart muscle. This condition is generally cause by one of two underlying factors, which in turn are often related to one another:

• Coronary artery disease. Coronary artery disease is characterized by hardening of the arteries (atherosclerosis) that supply the heart muscle with the oxygen-rich blood needed for it to pump efficiently. In CAD, the coronary arteries are gradually blocked with fatty plaque deposits that narrow the artery, thus reducing the flow of blood to the heart muscle (myocardium). In severe cases of coronary artery disease, the heart muscle is starved of oxygen (cardiac ischemia), forcing it work extra hard. Over time, the main pumping chamber of the heart (e.g., the left ventricle) expands and is unable to efficiently pump oxygen-rich blood to the rest of the body.
  
  
• Heart attack. A heart attack may be caused when plaque deposits in the coronary artery rupture, resulting in the formation of a blood clot that reduces blood flow to the heart muscle. As a result, the heart muscle may be permanently damaged and no longer able to function properly. Alternatively, the heart muscle may be stunned, or technically speaking, "hibernating," in which case the damage may be somewhat reversed with appropriate therapy.

It's important to note, however, that not all patients with coronary artery disease will develop ischemic cardiomyopathy. A number of factors are associated with increased risk for ischemic cardiomyopathy, in addition to atherosclerosis. These include diabetes, high blood pressure (hypertension), high cholesterol or a history of smoking.

Cardiomyopathy is the most common cause of heart failure in the United States. Although older men are most commonly affected, atherosclerosis is also a serious health concern for men and women of all ages, especially if risk factors (e.g., obesity, tobacco use) are present.