ABSTRACT
Coronary artery disease is an important predisposing factor for the development of heart failure. More specifically, myocardial infarction (MI) results in the immediate loss of contractile tissue which leads to regional left ventricular (LV) dysfunction. Following moderate-sized to large transmural MI, progressive structural and functional changes occur throughout the ventricle which are collectively known as ventricular remodeling. These changes are associated with the progression of clinical heart failure. The appropriate pharmacologic and surgical management of the patient with LV systolic dysfunction following MI is critical to optimize a patient’s functional capacity and prognosis. This chapter will review the epidemiology of LV dysfunction following MI, highlighting some important prognostic variables that contribute to the pathophysiology of progressive LV dysfunction and heart failure. The optimal pharmacologic and non-pharmacologic (i.e. surgical) management of patients with LV dysfunction secondary to ischemic heart disease will be reviewed based on available clinical data.
