In this article, two general, partly different, previous mechanisms of damage to the heart muscle will be examined under the final aspect of healing cardiovascular limitations of the heart with stem cells. The first mechanism concerns the vascular components of the heart muscle that lead to a local or general perfusion disorderCausesperfusion disorder. The restricted perfusion leads subsequently to reduce marco- and microcirculationCausesmicrocirculation of myocardium accompanied by damaged endotheliumCausesdamaged endothelium and destroyed myocytesCausesdestroyed myocytes. The diagnosis of these diseases’ reasons is mainly based on echocardiographic examinations. The focus in the second section is on the direct damage and destruction of the myocytes by inflammatory and virally induced processes. These reasons could lead to dilatation of the left or both ventricles accompanied by impaired contractility, finally resulting in reduced pumping performance of the heart. The causes of these diseases can only be clarified with a heart muscle biopsy, including histological, immunological, and molecular biological analyses. Targeted stem cell therapyStem cell therapy would be able for the reconstitution of vascular components and reperfusionTreatment outcomesreperfusion of the whole myocardium. On the other hand, applied stem cells could reduce or eliminate post-inflammatory or post-infectious fibrotic areas resulting from declining myocytes by preceding damages.