Restrictive cardiomyopathy

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Heart, front view

Heart, section through the middle

Cardiomyopathy - restrictive; Infiltrative cardiomyopathy

• Excessive tiredness (fatigue)
• Swelling of the feet and ankles
• Cough
• Difficulty breathing
  • especially with exertion
  • at night
  • when lying flat
• Easily fatigued (poor tolerance of exercise)
• Swelling of the abdomen

An examination may show signs of heart failure with fluid backup into the lungs or the systemic circulation (the extremities, gastrointestinal tract, and liver). The neck veins may be distended. Listening to the chest with a stethoscope (auscultation) may show lung crackles and may show abnormal or distant heart sounds.

Tests that may indicate restrictive cardiomyopathy (by showing symmetrical thickening of the ventricle walls and signs of abnormal heart function such as decreased cardiac output, and/or elevated end diastolic pressure) include:

• ECG (electrocardiogram)
• Echocardiogram and Doppler study
• Coronary angiography
• Chest x-ray
• Chest CT scan
• Chest MRI scan

Restrictive cardiomyopathy may be hard to differentiate from constrictive pericarditis. A biopsy of the heart muscle may be used to confirm the diagnosis.

A cardiac catheterization procedure can sometimes help differentiate the two cardiomyopathies by performing simultaneous left and right heart catheterization. In some cases, surgical exploration and biopsies are the only means to definitely distinguish restrictive cardiomyopathy from constrictive pericarditis.

Review Date: 05/31/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.