Restrictive Cardiomyopathy

Question 1

What is restrictive cardiomyopathy?

Answer 1

Normal or decreased volume of ventricles with bi-atrial enlargement

Question 2

What is the pathophysiology?

Answer 2

Inability to fill a ventricle with reduced compliance in its wall
Restrictive physiology

Question 3

What are the symptoms?

Answer 3

Dyspnoea
Fatigue
Embolic symptoms

Question 4

What are the signs?

Answer 4

Elevated JVP
Diastolic collapse
Hepatic enlargement
S3 and S4 heart sounds

Question 5

What are the investigations?

Answer 5

CHEST X-RAY - pulmonary congestion and atrial or cardiac enlargement
ELECTROCARDIOGRAM - Low voltage QRS and ST segment, T wave abnormalities
ECHOCARDIOGRAPHY - Symmetrical myocardial thickening and impaired ventricular filling
CARDIAC MR - abnormal myocardial fibrosis
CARDIAC CATHETERISATION - Distinguish between restrictive cardiomyopathy and constrictive pericarditis
ENDOMYOCARDIAL BIOPSY - Specific diagnosis
BASIC BLOODS

Question 6

What is the treatment?

Answer 6

Limited diuretic use
Beta blockers
Anticoagulants as required
Cardiac transplant