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Restrictive cardiomyopathy
Restrictive cardiomyopathy
• Disorder characterized by a
primary decrease in ventricular
compliance resulting in impaired
ventricular filling during diastole
 The myocardium is partially infiltrated
by noncontractile tissue or
extracellular material
 This infiltration of the myocardium
impairs the ability of the heart to dilate.
ETIOLOGY
• ■ Infiltrative causes: Amyloid, sarcoid
• ■ Noninfiltrative causes: Idiopathic,
scleroderma.
• ■ Other causes: Hemochromatosis ,
diffuse interstitial fibrosis,sarcoidosis,
postradiation fibrosis,metastatic
tumors,inborn errors of metabolism
Amyloidosis-heart
sarcoidosis
MORPHOLOGY
• Ventricles- normal/slightly enlarged
Cavities- not dilated
• Myocardium- firm and non
compliant
• Atria- biatreal dilation
• Microscopy-interstitial fibrosis
Clinical features
 Usually causes diastolic
dysfunction.
 Patients have signs and
symptoms of CHF with prominent
right-sided features.
Other restrictive conditions
Endomyocardial fibrosis
Loeffler endomyocarditis
Endocardial fibroelastosis
Endomyocardial fibrosis
Fibrosis of ventricular endocardium and
subendocardium
Extends from apex upward often invovling
tricuspid & mitral valves
Children & young adults
Africa & other tropical regions
Endomyocardial fibrosis
• Fibrous tissue markedly diminishes the volume &
compliance of affected chambers
• Induces a restrictive functional defect
• Ventricular mural thrombi & fibrous tissue results
from its organisation
• Etiology unknown
Restrictive cardiomyopathy
Restrictive cardiomyopathy

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