Patient presents with complaints consistent with ischemic cardiomyopathy.  Symptoms include dyspnea on exertion, fatigue, and lower extremity edema.  The patient reports a history of coronary artery disease, confirmed by previous cardiac catheterization revealing significant stenosis in the left anterior descending artery.  Electrocardiogram demonstrates sinus rhythm with left ventricular hypertrophy and nonspecific ST-T wave changes.  Echocardiography reveals reduced left ventricular ejection fraction (LVEF) currently estimated at 35%, with regional wall motion abnormalities indicative of prior myocardial infarction.  The patient's medical history is significant for hypertension, hyperlipidemia, and type 2 diabetes mellitus.  Current medications include lisinopril, metoprolol succinate, atorvastatin, and metformin.  Diagnosis of ischemic cardiomyopathy is made based on the combination of clinical presentation, history of coronary artery disease, and reduced LVEF.  Treatment plan focuses on optimal medical management of heart failure and coronary artery disease risk factors.  Patient education provided regarding medication adherence, lifestyle modifications including sodium restriction and cardiac rehabilitation, and the importance of follow-up appointments.  Referral to cardiology for further evaluation and consideration for coronary revascularization.  ICD-10 code I25.5, heart failure due to ischemic cardiomyopathy, is assigned.