Restrictive Cardiomyopathy

What is restrictive cardiomyopathy?

Restrictive cardiomyopathy (RCM) is a heart condition. Muscle tissue in your heart’s lower chambers (ventricles) becomes stiff, and the ventricles can’t fill with blood. This leads to reduced blood flow in your heart.

Other common names for restrictive cardiomyopathy are:

• Idiopathic restrictive cardiomyopathy.
• Infiltrative cardiomyopathy.

Who does restrictive cardiomyopathy affect?

Restrictive cardiomyopathy can affect anyone. But the underlying conditions that cause restrictive cardiomyopathy are more common in some people than others. For example, sarcoidosis, which causes restrictive cardiomyopathy, is most prevalent in Black people assigned female at birth.

How common is restrictive cardiomyopathy?

Cardiomyopathy is a common heart muscle disease. Up to 1 in 500 people may have it. But restrictive cardiomyopathy is the rarest type of cardiomyopathy — about 5% of all cardiomyopathies are restrictive cardiomyopathy.

How does restrictive cardiomyopathy affect me?

Your heart has four chambers made of muscle that contract to help pump your blood. The two upper chambers are atria, and the two lower chambers are ventricles.

Restrictive cardiomyopathy causes the ventricles to become rigid and unable to fill with blood completely. This condition affects how blood flows through your heart.

What are the symptoms of restrictive cardiomyopathy?

You may not have any symptoms of restrictive cardiomyopathy. But as the condition worsens, you might develop heart failure symptoms. These may include:

• Bloating or nausea.
• Chest pain (at rest or with exercise).
• Dizziness or fainting.
• Edema in your feet and legs.
• Fatigue.
• Heart palpitations.
• Shortness of breath (dyspnea).
• Weight gain.

What causes restrictive cardiomyopathy?

You may develop restrictive cardiomyopathy if you have:

• Amyloidosis.
• Connective tissue disease.
• Hemochromatosis (iron overload).
• Sarcoidosis.

You’re also more likely to develop restrictive cardiomyopathy after certain cancer treatments, including:

• Chemotherapy.
• Radiation therapy.

How do healthcare providers diagnose restrictive cardiomyopathy?

Your healthcare provider will perform a physical examination to diagnose restrictive cardiomyopathy. They'll listen to your heartbeat and take your blood pressure.

What tests do healthcare providers use to diagnose restrictive cardiomyopathy?

Your healthcare provider will order an echocardiogram to determine if your heart’s ventricles are functioning as they should. Your provider may recommend tests to see if you have an underlying condition that can cause restrictive cardiomyopathy. You may also have:

• Blood and urine tests.
• Chest X-ray.
• Cardiac CT scan.
• Exercise stress test.
• Heart MRI.
• Heart PET scan.
• Right heart catheterization.
• Myocardial biopsy.
• Genetic testing.

How do healthcare providers treat restrictive cardiomyopathy?

There's no specific treatment for restrictive cardiomyopathy. Your healthcare provider will treat the underlying cause of your condition. If you have heart failure symptoms, your provider may treat you with:

• Corticosteroids (if you have sarcoidosis).
• Diuretics.
• Medications to treat heartbeat irregularities (antiarrhythmics, beta blockers or calcium channel blockers).
• Therapeutic phlebotomy (blood removal for hemochromatosis).
• Medications to treat certain types of amyloidosis.

Some people with restrictive cardiomyopathy may ultimately need heart transplant surgery. Your provider may also recommend palliative care for this condition.

Are there complications of restrictive cardiomyopathy?

Restrictive cardiomyopathy can cause several complications:

• Heart arrhythmia.
• Heart failure.
• Thromboembolism or stroke.

How can I reduce my risk of restrictive cardiomyopathy?

Restrictive cardiomyopathy makes your heart work harder to pump blood. Talk to your healthcare provider about steps you can take to reduce your heart’s workload.

While you can’t prevent the underlying conditions that cause restrictive cardiomyopathy, you can help keep your heart healthy by:

• Controlling your blood pressure.
• Maintaining a healthy weight.
• Reducing your stress.

What can I expect if I have restrictive cardiomyopathy?

Restrictive cardiomyopathy is a complex condition. Talk with your healthcare provider about steps you can take to keep your heart healthy.

How long can you live with restrictive cardiomyopathy?

The survival rate for people with restrictive cardiomyopathy varies. Your healthcare provider can help you and your family know what to expect as the condition progresses.

How should I take care of myself if I have restrictive cardiomyopathy?

Follow your healthcare provider’s instructions and take all prescribed medications. Your healthcare provider may recommend lifestyle changes such as:

• Eating a healthy sodium-controlled diet.
• Exercising (as directed by your provider).

When should I seek care for restrictive cardiomyopathy?

If heart failure symptoms develop or worsen, call your healthcare provider. Call 911 if you have:

• Chest pain.
• Fainting.
• Sudden or severe shortness of breath.

A note from Cleveland Clinic

Restrictive cardiomyopathy occurs when muscles in your heart’s ventricles become rigid. The ventricles can’t fill with blood. Your heart must work too hard to pump blood, causing heart failure. Healthcare providers typically treat the symptoms of restrictive cardiomyopathy with medication.