Learn About Restrictive Cardiomyopathy (RCM)
View Main Condition: Cardiomyopathy
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.
Cardiomyopathy - restrictive; Infiltrative cardiomyopathy; Idiopathic myocardial fibrosis
In a case of restrictive cardiomyopathy, the heart muscle is of 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).
Although the main problem is abnormal filling of the heart, the heart may not pump blood strongly when the disease progresses. 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). Restrictive cardiomyopathy is a rare condition. The most common causes are amyloidosis and scarring of the heart from an unknown cause. It also can occur after a heart transplant.
Other causes of restrictive cardiomyopathy include:
- Cardiac amyloidosis
- Carcinoid heart disease
- Diseases of the heart lining (endocardium), such as endomyocardial fibrosis and Loeffler syndrome (rare)
- Iron overload (hemochromatosis)
- Sarcoidosis
- Scarring after radiation or chemotherapy
- Scleroderma
- Tumors of the heart
Symptoms of heart failure are most common. These symptoms often develop slowly over time. However, symptoms sometimes start very suddenly and are severe.
Common symptoms are:
- Cough
- Breathing problems that occur at night, with activity or when lying flat
- Fatigue and inability to exercise
- Loss of appetite
- Swelling of the abdomen
- Swelling of the feet and ankles
- Uneven or rapid pulse
Other symptoms may include:
- Chest pain
- Inability to concentrate
- Low urine output
- Need to urinate at night (in adults)
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
- Chemotherapeutic agents
- Medicines such as tafamidis that target abnormal proteins (amyloid fibrils)
- Liver transplantation
Additional treatments are also under investigation.
A heart transplant may be considered if the heart function is very poor and symptoms are severe.
Le Bonheur Children's Outpatient Center
Jeffrey Towbin is a Pediatric Cardiologist in Memphis,, Tennessee. Dr. Towbin is rated as an Elite provider by MediFind in the treatment of Restrictive Cardiomyopathy (RCM). His top areas of expertise are Restrictive Cardiomyopathy (RCM), Cardiomyopathy, Dilated Cardiomyopathy (DCM), Heart Transplant, and Cardiac Ablation.
Atrium Health Sanger Heart & Vascular Institute Kenilworth
John Holshouser is a Cardiologist and a Cardiac Electrophysiologist in Charlotte, North Carolina. Dr. Holshouser is rated as a Distinguished provider by MediFind in the treatment of Restrictive Cardiomyopathy (RCM). His top areas of expertise are Arrhythmias, Sick Sinus Syndrome, Ventricular Tachycardia, Pacemaker Implantation, and Cardiac Ablation. Dr. Holshouser is currently accepting new patients.
Atrium Health Sanger Heart & Vascular Institute Kenilworth
Brian Powell is a Cardiologist and a Cardiac Electrophysiologist in Charlotte, North Carolina. Dr. Powell is rated as a Distinguished provider by MediFind in the treatment of Restrictive Cardiomyopathy (RCM). His top areas of expertise are Arrhythmias, Cardiomyopathy, Atrial Fibrillation, Pacemaker Implantation, and Cardiac Ablation. Dr. Powell is currently accepting new patients.
People with this condition often develop heart failure that gets worse. Problems with heart rhythm or "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. Survival after diagnosis may exceed 10 years.
Contact your health care provider if you have symptoms of restrictive cardiomyopathy.
Summary: Transthyretin Amyloid Cardiomyopathy (ATTR-CM) is a serious and life-threatening condition where a protein called transthyretin (TTR) misfolds and builds up as amyloid fibrils in the heart muscle. This buildup causes the heart to become stiff, leading to restrictive cardiomyopathy and progressive heart failure. There are two forms of ATTR-CM: a hereditary or 'variant' form (vATTR-CM) caused by a g...
Summary: The goal of this protocol is to obtain information from individuals with cardiomyopathy and from their families in order to elucidate the molecular genetics of this disorder. This will provide the basis for future genetic counseling as well as contribute to elucidating the biology of normal and abnormal cardiac function.
Published Date: May 27, 2024
Published By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Elliott PM, Olivotto I. Diseases of the myocardium and endocardium. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 47.
Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heartfailure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79(17):1757-1780. PMID: 35379504 pubmed.ncbi.nlm.nih.gov/35379504/.
Hershberger RE. The dilated, restrictive, and infiltrative cardiomyopathies. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 52.