Use and ARB: Patients who need the renin-angiotensin blocade & who can't take an ace should take an arb which is chemically different. Hibernating myocardium is heart muscle that is viable (alive) but not functioning (non-contractile) because it has compromised circuation. Revascularization can restore function and increase the ejection fraction. Thallium scans are the test of choice.
Answered 3/19/2014
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Cardiomyopathy: Lack of sufficient blood flow to parts of the heart provokes a 'survival' mechanism that slows down the activity of that part until blood flow is restored. In ace intolerant patients, arbs or Aldactone (spironolactone) can be tried. Pacing allows full doses of beta-blockers to be used to help recovery of heart function.
Answered 6/24/2014
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