Contents
Cover image: Restrictive cardiomyopathy results from fibrosis or infiltrative disease of the myocardium, with the most frequent cause being amyloidosis | Medcomic/Jorge Muniz
Introduction
Restrictive cardiomyopathy (RCM) is a form of cardiomyopathy in which the walls are rigid, and the heart is restricted from stretching and filling with blood properly.
- Diastolic dysfunction
- L/C cardiomyopathy
Aetiology
- PRIMARY
- Löffler’s endocarditis
- Eosinophils in the heart
- Endocardial fibroelastosis (children)
- Fibrosis of endocardium + subendocardium
- Löffler’s endocarditis
- SECONDARY
- Infiltitative:
- Cardiac amyloidosis
- Familial amyloid cardiomyopathy
- TTR (transthyretin) mutation
- Senile cardiac amyloidosis (elderly)
- Wild-type TTR deposition in heart
- Familial amyloid cardiomyopathy
- Sarcoidosis
- Granulomas
- Hemochromatosis
- Cardiac amyloidosis
- Interstitial:
- Radiation → reactive oxygen species → Fibrosis
- Infiltitative:
Pathophysiology
Diagnosis
ECG
- Low amplitude QRS
Management
- Treat underlying cause