Restrictive cardiomyopathy resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Steven Bellm, M.D. [2]
Restrictive cardiomyopathy resident survival guide Microchapters |
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Overview |
Classification |
Causes |
Diagnosis |
Treatment |
Do's |
Dont's |
Overview
Restrictive cardiomyopathy is defined as heart-muscle disease with impaired ventricular filling usually due to increased stiffness. The diastolic volume of either or both ventricles is normal or decreased,the systolic function usually remains normal and wall thickness may be normal or increased. The symptoms and signs may consist of right (jugular venous pressure, peripheral edema, and ascites) or left ventricular failure (breathlessness and evidence of pulmonary edema).[1]
Classification
Restrictive cardiomyopathy | |||||||||||||||||||||||||||||||||||||
Myocardial | Endomyocardial | ||||||||||||||||||||||||||||||||||||
Nininfiltrative | Infiltrative | Storage Disease | |||||||||||||||||||||||||||||||||||
Causes
Common Causes
- Idiopathic cardiomyopathy
- Amyloisosis
- Sarcoidosis
- Endomyocardial fibrosis
- Radiation
- Toxic effects of anthracycline
Complete Diagnostic Approach
A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.
History and symptoms: ❑ Hints for etiology (history of pericarditis/ tuberculosis/ trauma DD:contrictive pericarditis or amyloidosis/ sarcoidosis))
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Physical examination: ❑ Vital signs:
❑ General appearance:
❑ Heart:
❑ Lungs:
❑ Abdomen:
❑ Extremities:
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Laboratory findings: ❑ Complete blood count
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Imaging and additional tests: ❑ Noninvasive imaging and tests:
❑ Biatrial enlargement, a normal or small left ventricular size with generally preserved systolic left ventricular function, and abnormal diastolic function
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Treatment
Symptomatic therapy
- Diuretics: for venous congestion in the pulmonary and systemic circulation, may cause signs of hypotension and hypoperfusion
Do's
Dont's
References
- ↑ Kushwaha SS, Fallon JT, Fuster V (1997). "Restrictive cardiomyopathy". N Engl J Med. 336 (4): 267–76. doi:10.1056/NEJM199701233360407. PMID 8995091.