Miami fell to 1-2 on its four-game road trip with Indiana winning on its own court for the 13th straight time.
West scored 30 points, grabbed a game-high seven rebounds and handed out five assists. The Pacers shot 56 percent and built a 15-point advantage heading into the closing period.
Paul George and Lance Stephenson both had 15 points for Indiana, which has an 18-3 home record for the season. That equals Miami for the best in the Eastern Conference.
The Heat missed out in its initial opportunity to become the first team in the East to reach 30 wins. Three teams in the Western Conference have already reached that mark.