Restrictive Cardiomyopathy

Condition Basics

What is restrictive cardiomyopathy?

Restrictive cardiomyopathy is a serious problem that makes your heart muscle stiff. When your heart muscle is stiff, it can't stretch to allow enough blood to enter its lower chambers, the ventricles. So blood that would normally enter the heart backs up in your circulatory system.

Most of the time, this leads to heart failure. Heart failure doesn't mean that your heart stops pumping. It means that your heart can't pump enough blood to meet your body's needs.

What causes it?

The cause of restrictive cardiomyopathy is sometimes never found. But there are a number of diseases or problems that can lead to it. These include:

• Cardiac amyloidosis. This is a buildup of an abnormal protein in the heart muscle.
• Hemochromatosis. This is a buildup of iron in the heart muscle.
• Sarcoidosis. This is a rare type of heart inflammation.
• Radiation therapy and chemotherapy. They are used to treat cancer.
• Carcinoid syndrome. This is a rare disease that causes certain chemicals to be released into the bloodstream. These chemicals can stiffen heart muscle.
• Löeffler's syndrome and endomyocardial fibrosis. These conditions can cause scar tissue in the heart.
• Genetic factors. You can inherit diseases, including Gaucher disease and Fabry's disease, that can lead to restrictive cardiomyopathy. But these diseases can be treated to prevent restrictive cardiomyopathy.

What are the symptoms?

You may not have any symptoms at first. Or you may have symptoms, such as feeling very tired or weak.

If your heart gets weaker, you may develop heart failure. When this happens, you may have other symptoms. These include:

• Shortness of breath, especially with activity.
• Tiredness.
• Trouble breathing when you lie down.
• Swelling in your legs.

How is it diagnosed?

Your doctor will ask questions about your symptoms and past health. He or she will want to know about recent illnesses and about heart disease in your family. Your doctor will listen to your heart and lungs and will check your legs for fluid buildup.

You may also have other tests. These include:

• An electrocardiogram, also known as an ECG or EKG.
• A chest X-ray.
• An echocardiogram.
• Cardiac catheterization.
• An MRI (magnetic resonance imaging).
• Blood tests.

In some cases, a doctor may want to look at a small sample of heart tissue, called a biopsy, to make a definite diagnosis.

How is restrictive cardiomyopathy treated?

Most of the time, treatment focuses on relieving symptoms, improving heart function, and helping you live longer. You may also have other treatment for the problem that is causing restrictive cardiomyopathy. For example, you may take medicines to get rid of too much iron in the heart muscle (hemochromatosis).

If you have heart failure, you will probably take several medicines to slow the disease and help you feel better.

Your doctor may suggest an implanted device such as an implantable cardioverter-defibrillator (ICD). An ICD can prevent life-threatening irregular heart rhythms.

If your condition is very bad, a heart transplant may be an option.

How can you care for yourself?

Self-care is an important part of your treatment. Self-care includes the things you can do every day to feel better, stay healthy, and avoid the hospital.

Take your medicines as prescribed.

This gives you the best chance of being helped by them.

Live a healthy lifestyle.

A heart-healthy lifestyle includes eating heart-healthy foods, staying at a healthy weight, and not smoking. If you think you may have a problem with alcohol or drug use, talk to your doctor. Get vaccinated against COVID-19, the flu, and pneumonia.

Ask your doctor about how you can exercise safely. People who have restrictive cardiomyopathy need to avoid doing too much, because their hearts can't increase blood flow during exercise.

Watch for signs that you're getting worse.

Weighing yourself every day to watch for sudden weight gain is a good way to do this. Keep a daily record of your weight and symptoms. Be sure you have a plan from your doctor so you know who to call if you gain weight suddenly or your symptoms change.