Restrictive Cardiomyopathy

Written by Kristeen Moore | Published on August 7, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Restrictive Cardiomyopathy

Restrictive cardiomyopathy refers to a weakened heart muscle that struggles to function properly. There are several types of cardiomyopathy, a disease of the muscles of the heart. Restrictive cardiomyopathy specifically refers to a condition in which the heart muscle is rigid. This involves the walls of the lower chambers of the heart (the ventricles). Because the walls are rigid, they lack the flexibility to expand when the ventricles fill with blood.

Restrictive cardiomyopathy, the rarest form of cardiomyopathy, is a condition in which the walls of the lower chambers of the heart (the ventricles) are abnormally rigid and lack the flexibility to expand as the ventricles fill with blood. Eventually, the heart will lose the ability to pump blood properly, leading to heart failure (Cleveland Clinic).

Some patients may not realize that they have this condition. Others may experience a range of uncomfortable symptoms.

Causes of Restrictive Cardiomyopathy

Restrictive cardiomyopathy is a rare condition that is sometimes attributed to complications from a heart transplant. In some cases, the exact cause of restrictive cardiomyopathy is unknown.

Some of the most common causes of restrictive cardiomyopathy include:

  • abnormal buildup of proteins in the heart (amyloidosis)
  • inflammation of the heart muscle
  • too much iron in the blood (hemochromatosis)
  • heart scarring from cancer treatments
  • tumors on the heart

Risk Factors for Restrictive Cardiomyopathy

According to the National Heart, Lung, and Blood Institute, restrictive cardiomyopathy is most common in older adults (NHLBI). This heart condition can occur for a variety of reasons, and you may be at a higher risk if you have:

  • a family member with cardiomyopathy
  • a family history of other types of heart disease
  • coronary heart disease
  • obesity
  • diabetes
  • high blood pressure (hypertension)
  • alcoholism

Symptoms of Restrictive Cardiomyopathy

Common symptoms of restrictive cardiomyopathy include:

  • chest pain
  • shortness of breath
  • cough
  • loss of appetite
  • unintentional weight loss
  • excessive fatigue
  • abdominal swelling
  • rapid pulse
  • decreased consciousness
  • swelling of the feet
  • low urine production
  • fainting during exercise

Some patients with this heart condition may not know they have it until the later stages of the disease. This can make treatment more challenging because you may not be diagnosed early enough to prevent further heart damage.

Diagnosing Restrictive Cardiomyopathy

A physical exam may reveal a swollen abdomen and limbs and an enlarged vein in the neck. Your doctor will also perform a variety of tests to check your heart function, such as:

  • chest X-ray
  • computed tomography (CT) scan to create detailed X-ray images of internal structures
  • nuclear heart scan (use of a radioactive substance (tracer) and special cameras to create images of the heart
  • electrocardiogram to record the heart’s electrical activity
  • magnetic resonance imaging (MRI) scan using radio waves to create detailed pictures of the heart

Testing of the blood for the iron content and the urine for protein can reveal important diagnostic information

Have your heart checked periodically if cardiomyopathy runs in your family—even if you aren’t currently experiencing any symptoms.

Treatment Options

Effective treatment for restrictive cardiomyopathy depends on a proper diagnosis. Prescription medications can help thin the blood or control abnormal heartbeats. Your doctor may prescribe diuretics to remove excess fluids in the body that cause edema (swelling). Chemotherapy may be used if the cause of restrictive cardiomyopathy is related to tumors on the heart.

Severe cases of this condition will require a heart transplant. This procedure involves the replacement of your heart with a healthy donor heart. Keep in mind that you will need follow-up care after a transplant to ensure its success. Your doctor won’t perform a heart transplant if you have poor lifestyle habits or if you have other severe underlying health conditions, such as cancer, HIV, or hepatitis.

Lifestyle changes can bolster the effectiveness of medical treatment measures. These include:

  • losing weight if obese
  • avoiding alcohol
  • quitting smoking
  • getting adequate sleep
  • reducing blood pressure
  • avoiding stress

Possible Complications

Restrictive cardiomyopathy can lead to other complications with the heart, including:

  • mitral valve regurgitation (a condition in which the valves of the heart can’t close properly and blood leaks backward into the heart chambers)
  • arrhythmias (abnormal heart beats)
  • fluid buildup in the lungs (pulmonary edema)
  • heart attack
  • a build-up of scar tissue in place of heart muscle (in rare cases)

Outlook for Restrictive Cardiomyopathy

According to the National Institutes of Health, the average survival for newly diagnosed patients with restrictive cardiomyopathy is nine years. (Medline Plus) This is due to the fact that your heart will weaken over time. If you meet the criteria for heart transplantation, this method of treatment can improve your outcome.

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