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Prolonged bed rest in the treatment of ischemic cardiomyopathy.

Ten patients with ischemic cardiomyopathy and with marked cardiomegaly and “intractable” congestive heart failure were studied to determine their response to prolonged complete bed rest therapy. Ischemc cardiomyopathy is similar to other types of cardiomyopathy with severe congestive heart failure, cardiomegaly and electrocardiographic abnormalities, but is distinguished by a history of myocardial infarction or angina pectoris. The prognosis is poor since patients are subject to all the complications of cardiomyopathy, as well as to the sequelae of ischemic heart disease. A proper therapeutic approach encompasses treatment of the heart muscle disease, as well as of the ischemic basis. Management of patients with ischemic cardiomyopathy by prolonged, complete bed rest resulted in initial clinical improvement in all patients. Four patients experienced partial reduction in heart size. Two of these patients lived four and eight years, respectively, after discharge and two are presently living seven and eight months after completing bed rest therapy.