Cardiomyopathy

Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is the least common type of cardiomyopathy. It occurs when the pumping chambers of the heart (ventricles) become stiff and rigid. Over time, part of the heart muscle is replaced with scar tissue, making it difficult for the ventricles to fill with blood and pump it throughout the body.

RCM can affect people of any age but is more common in older adults. If left untreated, it can lead to complications such as heart failure and irregular heart rhythms.

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What Causes RCM?

The cause of restrictive cardiomyopathy is often unknown. In some cases, it may be linked to other medical conditions, including:

Transthyretin amyloid cardiomyopathy (ATTR-CM). The buildup of abnormal proteins in the heart.
Hemochromatosis. The buildup of iron in the body, causing damage to the heart and other organs.
Sarcoidosis. A chronic, inflammatory disease that causes lumps of cells to form in the body’s organs, including the heart and lungs.

Symptoms of Restrictive Cardiomyopathy

In its early stages, there may only be mild or no symptoms. As the disease progresses, symptoms may include:

Coughing
Shortness of breath
Fatigue
Loss of appetite
Swelling of the feet, ankles or abdomen
Irregular or rapid pulse

How Is RCM Diagnosed?

If a patient has any of the symptoms listed, a complete family and medical history will be taken and a physical exam performed. If RCM is suspected, one or more of the following diagnostic tests may be performed:

Chest X-ray. Evaluates any enlargement of the heart and reveals congestion in the cardiac blood vessels.
Cardiac Magnetic Resonance (CMR) scan. A non-invasive test that uses magnetic radio waves to generate a detailed image of the heart.
Electrocardiogram (ECG). A non-invasive test that measures the electrical activity of the heart by recording the signals it produces.
Echocardiogram. An ultrasound exam to evaluate the heart’s motion, blood flow and pumping efficiency of the ventricles.
Exercise stress test. Evaluates how well the heart performs during exercise.
Cardiac catheterization. A minimally invasive procedure to measure the pressure in and around the heart. In some cases, the procedure may also be used to take a biopsy of the heart muscle to check for damage.

Personalized Treatment Plans for Restrictive Cardiomyopathy

Treatment for RCM depends on how advanced the disease is, the severity of symptoms and the cause. There is no cure, but treatment can help to manage symptoms, improve quality of life and reduce the risk of complications.

Treatment plans may include one or more of the following:

: In some cases, early-stage RCM may be effectively managed with lifestyle modifications alone. Recommendations may include:

Reach and maintain a healthy weight

Eat a heart-healthy, low-sodium diet

Get regular, moderate exercise as approved by your doctor

Quit smoking

Limit or eliminate alcohol use

Manage stress levels

Monitor fluid intake

Get enough quality sleep
: In addition to lifestyle modifications, there are a variety of medications that may be prescribed to slow the progression of RCM, manage symptoms and, in some cases, improve overall heart health. The type of medication will depend on each person’s case, the severity of symptoms and the cause. Examples of potential drug therapies include ACE inhibitors, diuretics, beta blockers and antiarrhythmic drugs.
: Some patients with RCM may develop complications such as heart failure, irregular heartbeat or sudden cardiac death. To reduce these risks, artificial pacemakers and implantable cardioverter-defibrillators may be recommended as part of the total treatment plan. These devices have been shown to help prevent sudden cardiac death, improve symptoms and reduce risk of hospitalization.
: Patients with advanced disease who are not responding adequately to medical therapy may be considered for heart transplant surgery.

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For an appointment with one of our cardiomyopathy specialists, call 216-844-3800.

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