CARDIOMYOPATHY, RESTRICTIVE

Cardiomyopathy is a disease of the heart muscle that prevents the muscle from generating the normal force of contraction. The result is that the heart does not effectively pump blood (heart failure). Restrictive cardiomyopathy means the heart is restricted in its ability to contract because the inner lining of the heart becomes stiff. The heart does not expand properly when filling. The heart muscle tries to thicken from the outside to make more muscle for contraction, but improper filling of the heart causes heart failure.

Much of the time the cause of restrictive cardiomyopathy is unknown. It may be caused by diseases such as amyloidosis (abnormal depositing of protein in some body tissues) or sarcoidosis (abnormal inflammation of lymph nodes and other tissues). It may also be caused by an inflammatory or autoimmune condition. Excessive alcohol consumption can worsen cardiomyopathy. Biopsy of the tissues may be performed to confirm the diagnosis. Cardiomyopathy is much less common than heart disease from coronary artery disease or heart valve abnormalities.

Cardiomyopathy can cause heart failure. Most persons with this condition experience fatigue, decreased ability to exercise, and shortness of breath. There may be swelling in the legs or feet, chest pain, or palpitations (feeling of the heart beating too fast). Symptoms lead to an examination that shows an abnormal electrocardiogram (ECG) and a heart that looks enlarged on examination and on a chest radiograph (x-ray). Echocardiography (an ultrasound examination of the heart) or angiography (radiographic test to assess blood flow through the heart) may be performed to assess the pumping function of the heart.

Therapy for cardiomyopathy aims at the symptoms of heart failure and abnormal heart rhythms (arrhythmias). If a cause of cardiomyopathy is known, the patient is treated for that condition. Diuretics reduce the fluid in the blood to reduce the workload of the heart.

Antiarrhythmic medications are used for arrhythmias. Medications that suppress immune function or corticosteroid medicines may be used when indicated to fight the condition causing the cardiomyopathy. If pumping function is seriously decreased and the symptoms of heart failure are worsening, heart transplantation may be needed.

• Decrease the sodium (salt) and excess fluid in your diet to help this.
• Take all prescribed medications as directed.
• Exercise when you have clearance from your physician.

• Avoid alcohol consumption.
• Do not forget to take your medications.

• If you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting.

Contact the American Heart Association at 1-800-242-8721 and ask for the literature department.




Left: normal heart. Right: restrictive cardiomyopathy. (Drawing by David Fisher. From Kinney MR, Packa DR: Andreoli's comprehensive cardiac care, ed 8, St Louis, 1996, Mosby. Used by permission.)

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