Restrictive cardiomyopathy refers to a set of changes in how the heart muscle functions. These changes cause the heart to fill poorly (more common) or squeeze poorly (less common). Sometimes, both problems are present.
In a case of restrictive cardiomyopathy, the heart muscle is normal size or slightly enlarged. Most of the time, it also pumps normally. However, it does not relax normally during the time between heartbeats when the blood returns from the body (diastole).
When the disease progresses, the heart may not pump blood strongly. The abnormal heart function can affect the lungs, liver, and other body systems. Restrictive cardiomyopathy may affect either or both of the lower heart chambers (ventricles). It is very often linked to a disease of the heart muscle.
Restrictive cardiomyopathy is a rare condition. The most common causes are amyloidosis and scarring of the heart from an unknown cause (idiopathic myocardial fibrosis). It also can occur after a heart transplant.
Other causes of restrictive cardiomyopathy include:
The condition causing the cardiomyopathy is treated when it can be found.
Few treatments are known to work well for restrictive cardiomyopathy. The main goal of treatment is to control symptoms and improve quality of life.
The following treatments may be used to control symptoms or prevent problems:
Blood thinning medicines
Chemotherapy (in some situations)
Diuretics to remove fluid and help improve breathing
Medicines to prevent or control abnormal heart rhythms
Steroids for some causes
A heart transplant may be considered if the heart function is very poor and symptoms are severe.
People with this condition often develop heart failure that gets worse. Problems with "leaky" heart valves may also occur.
People with restrictive cardiomyopathy may be heart transplant candidates. The outlook depends on the cause of the condition, but it is usually poor. Average survival after diagnosis is 9 years.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of restrictive cardiomyopathy.
Hare JM. The dilated, restrictive, and infiltrative cardiomyopathies. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 68.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.