Restrictive Cardiomyopathy: Causes, Symptoms, Treatment

What is Restrictive Cardiomyopathy?

Restrictive cardiomyopathy or simply RCM is the abnormal functioning of the heart muscles. The condition results in a restrictive filling of the ventricles whereby the heart muscles and wall thickness contract normally, but the filling phase is not normal. Under normal circumstances, the heart muscles should relax and allow for the ventricular chambers to fill with blood. Because in this case, the muscles remain stiff, a backup of blood is likely to form into the top chambers of the heart, hence restrictive cardiomyopathy causes symptoms similar to those of a heart attack.

Restrictive Cardiomyopathy

Causes of Restrictive Cardiomyopathy

In most cases, the causes of restrictive cardiomyopathy may not be conclusive according to research. However, some of the suspected causes are:

  • Amyloidosis can cause restrictive cardiomyopathy. It is an abnormal protein normally produced in the bone marrow and gets deposited in body organs. In this case, it is deposited in the heart muscles.
  • Hemochromatosis may cause restrictive cardiomyopathy. An iron disorder that prompts the body to produce excess iron.
  • Another cause of restrictive cardiomyopathy is chemotherapy. When the chest is exposed to radiation during treatment, it may affect the normal functioning of body organs.
  • Abnormal adhesions is a build up of tissue or lymph nodes in body organs like the heart and can lead to this condition. It is also known as sarcoidosis.

Signs and Symptoms of Restrictive Cardiomyopathy

Restrictive cardiomyopathy manifests itself differently to different people. While some may not experience any symptom whatsoever, there are those with reported severe symptoms. These includes:

  • Fatigue is the primary symptom of restrictive cardiomyopathy. Because you know your body better, you are able to tell when you are abnormally tired and seek attention from your medical practitioner.
  • An increase in weight gain may be seen. A questionable increase in weight will prompt you to sense when things are not right.
  • Another sign of restrictive cardiomyopathy could be difficulty in exercising. It is important to see a doctor if you have problems while exercising which was not the case before.
  • Experiencing shortness of breath while exercising and sometimes while resting.
  • Abnormal nausea, poor appetite and bloating.
  • Irregular heart beats or palpitations.
  • Experiencing chest pain while resting or after an activity.
  • Although it is not common, fainting might occur in the case of severe irregular heart rhythms.
  • Decreased concentration levels.

Tests to Diagnose Restrictive Cardiomyopathy

Restrictive cardiomyopathy diagnosis is only carried out after some of the symptoms are present. It may be difficult to come up with a conclusive diagnosis in the absence of the symptoms. Once your doctor suspects it, he is likely to recommend the following tests:

  • Exercise test may be conducted for diagnosing restrictive cardiomyopathy. It is also called a treadmill test or a stress test. The purpose of this test is to make your heart work hard and beat fast. This test helps your doctor see how your heart behaves under pressure.
  • Blood test. An amount of blood is drawn from your vein using a needle.
  • Chest X-Ray. The purpose of this procedure for restrictive cardiomyopathy is to diagnose whether there is water retention in your lungs and to show if your heart is enlarged.
  • The use of special medical gadgets to show the hearts electrical activity. Some of these gadgets have the ability to sense an abnormal rhythmic heart rate and start the recording automatically. While for others, you have to press a start button in the event of experiencing the symptoms. It is also known as Holter and Events monitors test.
  • Another test for restrictive cardiomyopathy is EKG (Electrocardiogram) test which shows the speed and rhythmic activities of the heart. During this test, electrical signals going through the heart are recorded according to their strength and timing. It is a gadget that a patient wears on their chests.
  • Echocardiography. This test involves the use of sound waves to form a moving picture in your heart. It reveals the size and shape of your heart, and how well it is functioning. Echocardiography is classified into to two.
    • Stress echo. It is part of the stress test used to diagnose a coronary heart disease by establishing whether there is a decrease in blood flow to your heart.
    • Transesophageal echo. It is carried to present a view of the back of your heart. Soundwave wands are put in a special tube which is then passed through your throat and into the esophagus. Because this procedure can be comfortable and painful, a patient is given relaxation medicine and numbed at the throat using numbing spray.

The following diagnostic procedures ensure that a diagnosis of restrictive cardiomyopathy is confirmed to be correct.

  • Cardiac catheterization procedure for restrictive cardiomyopathy enables your doctor to gather blood samples while checking your arteries for any possible blockage by the use of X-ray. It also checks the blood flow and pressure in your heart. For this procedure to be successful, a catheter is inserted in either your arm, neck, or groin and passed through to your heart.
  • Coronary angiography is another procedure for diagnosing restrictive cardiomyopathy which involves the use of a catheter to inject dye into your coronary arteries. X-ray is then carried out to enable your doctor to see the blood pressure in your heart chambers.
  • Myocardial biopsy is the removal of a small part of the muscle tissue to carry out a heart biopsy exam. Even though this test is usually carried out alongside the cardiac catheterization, it can be done separately.
  • Genetic testing for restrictive cardiomyopathy: Research shows that there is a connection between individual genetic mutations and heart diseases. This follows a prior research indicating that restrictive cardiomyopathy is not inherited. This test will help your doctor piece together findings to see whether there could be any signs likely to give a clear picture of the presence of restrictive cardiomyopathy.

Treatment for Restrictive Cardiomyopathy

Though there is no known treatment of restrictive cardiomyopathy, doctors provide medicines that is able to suppress the symptoms as well as prevent your condition from getting worse and curbing the chances of developing further complications such as high blood pressure. Some of the medicines that are most likely to be recommended are:

  • Beta blockers for treating restrictive cardiomyopathy reduces your heart’s workload hence slowing the heart rate and eventual irregular heart imbalance.
  • Diuretics can help in managing the symptoms of restrictive cardiomyopathy. They increase urine production hence clearing your body off unwanted toxins in the body.
  • Digoxin regulates and makes your heart beat strong.

Lifestyle Changes for Restrictive Cardiomyopathy

Restrictive cardiomyopathy can be managed through a total change in your lifestyle. Your doctor will recommend that you:

  • Cut some few calories if he thinks you are overweight.
  • Quit smoking. It causes a build-up of fatty material along the lining of the arteries hence narrowing them.
  • Eat a healthy diet while cutting down on the amount of salt in your diet is an excellent lifestyle change for restrictive cardiomyopathy.
  • Manage and if possible do away with stress and try as much as possible to get enough sleep.
  • Reduce your alcohol intake. It would do a patient justice if they decide to quit alcohol for the sake of their wellness.
  • The best exercises for your condition.
  • Take recommended medicine and hospital appointments without fail.

Coping with Restrictive Cardiomyopathy

Being diagnosed with a life-threatening disease such as restrictive cardiomyopathy can cause grievous effects to your overall health. But with all said and done, it is how you approach the situation that determines how manageable the condition becomes. You can apply the following coping tips to enable you to lead a normal life.

  • Read as much as you can about restrictive cardiomyopathy. Develop an optimistic attitude towards the disease and make up your mind to research about the same. It is only by understanding it by yourself that you can be able to effectively manage it.
  • Speak about your restrictive cardiomyopathy. Through identifying a group of people who are going through the same, you will be able to discuss it. Sharing what you are going through makes feel relieved.
  • Surround yourself with people who care. By involving your family members, you will find that implementing the lifestyle changes will be easier to cope. They are the people who will encourage you to keep walking.
  • Know when to consult your doctor. Learn to listen to your body and identify symptoms that need immediate attention. Additionally, have your doctor train you on what to do to give yourself first aid before getting to the hospital. Train your partner and family as well on the immediate action they should take in case of an emergency.
  • Be happy. Despite your restrictive cardiomyopathy, strive to find happiness in the struggle. Allowing your body to undergo stress can be detrimental to the condition. Do not keep to yourself. Get involved in activities where you will be able to meet and mingle with people. This will make you forget about your struggles and help in better coping.

Prevention of Restrictive Cardiomyopathy

As much as you would want to, there is actually nothing much you can do to prevent restrictive cardiomyopathy. Early detection of the causes might slightly prevent it.


The restrictive cardiomyopathy is a rare but dangerous disease that affects the myocardium. According to research, it is said that it is common in girls than in boys. It is important to take note of the family history of heart diseases. It can come in handy and aid the diagnosis of restrictive cardiomyopathy. It is possible to live a long blissful life even with this condition. Remaining optimistic and accepting your condition is the first step towards successfully managing restrictive cardiomyopathy.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 16, 2017

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