08-19-2018, 07:07 PM
Restrictive cardiomyopathy is a diastolic dysfunction that causes reduced diastolic filling and decreased ventricular compliance.
Restrictive cardiomyopathy is most frequently caused by the following:
• Amyloidosis
• Myocardial fibrosis after open heart surgery
• Radiation
The most common cause of restrictive cardiomyopathy is amyloidosis.
Common secondary causes of restrictive cardiomyopathy often involve infiltration of the myocardium and include:
• Sarcoidosis
• Loeffler endocarditis
• Amyloidosis
• Systemic sclerosis
• Hemochromatosis
• Metastatic tumors
• Endocardial fibroelastosis (thick fibroelastic tissue in the endocardium of young children)
Loeffler endocarditis is a form of restrictive cardiomyopathy that is associated with hypereosinophilic syndrome and accompanying myocardial eosinophilic infiltrates.
Clinical findings include progressive left and right sided heart failure and low voltage ECG, with diminished QRS amplitude.
The diagnosis of restrictive cardiomyopathy is commonly made using cardiac catheterization and echocardiography.
Constrictive pericarditis and restrictive cardiomyopathy present similarly due to the fact that they both cause ventricular diastolic dysfunction. The following heart sounds can help differentiate between the two:
• Constrictive pericarditis - pericardial knock (an accentuated heart sound occurring slightly earlier than a third heart sound, which may be audible and rarely is palpable).
• Restrictive cardiomyopathy - S3 heart sound
Classic history seen with constrictive pericarditis:
• Pericarditis
• Trauma
• Cardiac surgery
• Systemic disease that affects the pericardium (e.g. tuberculosis, connective tissue disease, malignancy)