Restrictive cardiomyopathy refers to changes in and weakening of the heart muscle, which causes the heart to fill poorly, squeeze poorly, or both.
Cardiomyopathy – restrictive; Infiltrative cardiomyopathy
Causes, incidence, and risk factors
In restrictive cardiomyopathy, the heart is of normal size or only slightly enlarged. However, it cannot relax normally during the time between heartbeats when the blood returns from the body (diastole).
Later in the disease, the heart may not pump blood strongly. The abnormal heart function can affect the lungs, liver, and other body systems. Restrictive cardiomyopathy may affect either or both ventricles. It is usually associated with a disease of the heart
Although restrictive cardiomyopathy is a rare condition, the most common causes are
Other causes of restrictive cardiomyopathy include:
Carcinoid heart disease
Diseases of the heart lining (endocardium), such as endomyocardial fibrosis and Loeffler’s syndrome (rare)
Iron overload (hemochromatosis)
Scarring after radiation or chemotherapy
Tumors of the heart
Symptoms of heart failure are most common. Usually, these symptoms develop slowly over time. However, sometimes symptoms start very suddenly and are severe.
Common symptoms are:
or shortness of breath
- At night
- Especially with activity
- When lying flat
Fatigue, poor exercise tolerance
- Loss of appetite
Swelling of the abdomen Swelling of the feetand ankles
- Uneven or rapid pulse
Other symptoms may include:
- Chest pain
- Decreased alertness or concentration
- Low urine production
- Need to urinate at night (in adults)
Signs and tests
An examination may show:
Enlarged (distended) or bulging neck veins
Lung crackles and abnormal or distant
heart soundswhen listening to the chest with a stethoscope
Fluid backup into the hands and feet
Tests for restrictive cardiomyopathy include:
Cardiac catheterizationand coronary angiography
Chest CT scan
Chest x-ray ECG(electrocardiogram) Echocardiogramand Doppler study MRI of the heart
- Nuclear heart scan (MUGA, RNV)
Serum iron studies
- Serum or
Restrictive cardiomyopathy may be hard to tell apart from
When the cause of any cardiomyopathy can be found, that condition is treated.
Few treatments are known to be effective for restrictive cardiomyopathy. The main goal of treatment is to control symptoms and improve quality of life.
The following treatments may be used to control symptoms or prevent problems:
Blood thinning medications, either aspirin or warfarin
Chemotherapy (in some situations)
Diuretics to remove fluid and help improve breathing
Medications to prevent or control uneven or abnormal heart rhythms
Steroids for some causes
People with this condition often develop heart failure that gets worse. Problems with
People with restrictive cardiomyopathy may be heart transplant candidates. The outlook depends on the cause of the condition, but it is usually poor. Average survival after diagnosis is 9 years.
Calling your health care provider
Call your health care provider if you have symptoms of restrictive cardiomyopathy.