Restrictive Cardiomyopathy

The heart muscle needs to stretch in order to carry blood into the ventricles, the lower chambers of the heart. Restrictive cardiomyopathy is an uncommon condition in which the heart muscle stiffens, causing blood to instead flow into the circulatory system. If left untreated, restrictive cardiomyopathy can lead to heart failure, a condition in which the heart is unable to provide the body's cells with the oxygen and nutrients they require.

Causes of Restrictive Cardiomyopathy

The causes of restrictive cardiomyopathy are not always identifiable, but in some cases it is linked to the following:

  • Scar-tissue buildup
  • Abnormal protein buildup in the heart muscle
  • Chemotherapy
  • Exposure of the chest to radiation
  • Excess iron in the heart

Various systemic diseases, including sarcoidosis, are often linked to restrictive cardiomyopathy.

Symptoms of Restrictive Cardiomyopathy

Restrictive cardiomyopathy may be asymptomatic, or may present with the following symptoms:

  • Fatigue
  • Weakness
  • Edema (fluid buildup)
  • Shortness of breath
  • Enlarged abdomen
  • heart palpitations
  • Arrhythmia

In approximately one-third of cases, restrictive cardiomyopathy causes embolic complications, such as blood clots.

Diagnosis of Restrictive Cardiomyopathy

Confirming a diagnosis of restrictive cardiomyopathy begins with a complete physical exam, during which the physician listens to the patient's heart and lungs, and looks for edema in the legs. In certain cases, the following tests are performed:

  • Electrocardiogram (EKG)
  • Chest X-ray
  • Echocardiogram
  • CT scan
  • MRI scan
  • Treadmill stress test
  • Blood tests
  • Cardiac catheterization

Occasionally, a biopsy of the heart muscle is performed to diagnose restrictive cardiomyopathy.

Treatment of Restrictive Cardiomyopathy

Treatment of restrictive cardiomyopathy depends on its cause, although it is usually treated with a combination of medications, including diuretics and angiotensin-converting enzyme (ACE) inhibitors, to prevent heart failure. Lifestyle changes, including restricting salt intake, and limiting or modifying exercise, may also be recommended. The most severe cases of restrictive cardiomyopathy may require heart transplants.

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