Restrictive cardiomyopathy - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2022-12-14T18:43:55Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
			*[[Constrictive pericarditis]]

	{{Cardiomyopathy DDX}}		{{Cardiomyopathy DDX}}

Rossdonaldson1: /* See Also */

2022-12-14T18:42:49Z

Rossdonaldson1: /* Background */

2022-12-14T18:42:25Z

Background

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	**Ventricular EF typically normal, though systolic function may deteriorate in absence of compensatory hypertrophy		**Ventricular EF typically normal, though systolic function may deteriorate in absence of compensatory hypertrophy
	*If nodal/conduction tissues affected by infiltrative/fibrotic process, may cause SA or [[AV block]]		*If nodal/conduction tissues affected by infiltrative/fibrotic process, may cause SA or [[AV block]]
	*Must distinguish from ~~constrictive~~ [[pericarditis]]		*Must distinguish from [[constrictive pericarditis]]

	===Causes of Restrictive Cardiomyopathy===		===Causes of Restrictive Cardiomyopathy===

Rossdonaldson1: /* References */

2022-06-07T21:40:39Z

References

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	==References==		==References==
	<references/>		<references/>
	https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/restrictive-cardiomyopathy		*https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/restrictive-cardiomyopathy

	[[Category:Cardiology]]		[[Category:Cardiology]]

Rossdonaldson1: /* Evaluation */

2022-06-07T21:40:21Z

Evaluation

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	==Evaluation==		==Evaluation==
	*Consider if [[CHF]] but no evidence of cardiomegaly or systolic dysfunction		===Workup===
	*[[ECG]]		*[[ECG]]
	**Typically nonspecific ST/TW abnormalities		**Typically nonspecific ST/TW abnormalities
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	**Elevated LV filling pressures, impaired longitudinal contraction		**Elevated LV filling pressures, impaired longitudinal contraction
	**+/- dilated atria, myocardial hypertrophy		**+/- dilated atria, myocardial hypertrophy

			===Diagnosis===
			*Consider if [[CHF]] but no evidence of cardiomegaly or systolic dysfunction
	*Definitive diagnosis may require MRI, catheterization, biopsy		*Definitive diagnosis may require MRI, catheterization, biopsy

Rossdonaldson1: /* Causes of Restrictive Cardiomyopathy */

2022-06-07T21:39:34Z

Causes of Restrictive Cardiomyopathy

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	===Causes of Restrictive Cardiomyopathy===		===Causes of Restrictive Cardiomyopathy===
	*Idiopathic		*Idiopathic
	*Familial non=infiltrative disease		*Familial non-infiltrative disease
	*Infiltrative disease ([[amyloidosis]], [[sarcoidosis]], Gaucher, Hurler)		*Infiltrative disease ([[amyloidosis]], [[sarcoidosis]], Gaucher, Hurler)
	*Storage diseases ([[hemochromatosis]], Fabry, glycogen/lysosomal storage diseases)		*Storage diseases ([[hemochromatosis]], Fabry, glycogen/lysosomal storage diseases)

Rossdonaldson1 at 21:39, 7 June 2022

2022-06-07T21:39:17Z

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	*Must distinguish from constrictive [[pericarditis]]		*Must distinguish from constrictive [[pericarditis]]

	==Clinical ~~features~~==		===Causes of Restrictive Cardiomyopathy===
			*Idiopathic
			*Familial non=infiltrative disease
			*Infiltrative disease ([[amyloidosis]], [[sarcoidosis]], Gaucher, Hurler)
			*Storage diseases ([[hemochromatosis]], Fabry, glycogen/lysosomal storage diseases)
			*[[Diabetes]]
			*[[Scleroderma]]
			*Endomyocardial fibrosis (hypereosinophilic syndrome, medication toxicity)
			*Radiation, chemotherapy (doxorubicin)
			*Metastatic disease, [[carcinoid syndrome]]

			==Clinical Features==
	*Exertional [[dyspnea]], orthopnea, PND		*Exertional [[dyspnea]], orthopnea, PND
	*Peripheral edema		*Peripheral edema
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Cardiomyopathy DDX}}		{{Cardiomyopathy DDX}}

	~~===Restrictive cardiomyopathy etiology DDX===~~
	**Idiopathic
	**Familial non=infiltrative disease
	**Infiltrative disease ([[amyloidosis]], [[sarcoidosis]], Gaucher, Hurler)
	**Storage diseases ([[hemochromatosis]], Fabry, glycogen/lysosomal storage diseases)
	**[[Diabetes]]
	**[[Scleroderma]]
	**Endomyocardial fibrosis (hypereosinophilic syndrome, medication toxicity)
	**Radiation, chemotherapy (doxorubicin)
	**Metastatic disease, [[carcinoid syndrome]]

	==Evaluation==		==Evaluation==
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	***Avoid [[digoxin]] in amyloidosis as sensitivity to dig-induced arrhythmias common		***Avoid [[digoxin]] in amyloidosis as sensitivity to dig-induced arrhythmias common

			==Disposition==

	==See Also==		==See Also==
	*[[Cardiomyopathy (~~Main~~)]]		*[[Cardiomyopathy (main)]]

			==External Links==

	==References==		==References==

ClaireLewis at 16:02, 26 September 2019

2019-09-26T16:02:18Z

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	==Background==		==Background==
	*Muscle is stiff from fibrosis or infiltrating process		*Muscle is stiff from fibrosis or infiltrating process (e.g. [[amyloidosis]], [[hemochromatosis]])
	*EF is usually normal		*Form of diastolic dysfunction (difficulty filling); ventricular endocardial thickening or myocardial infiltration-->high filling pressures, impaired diastolic filling-->[[mitral regurgitation\|mitral]] and/or tricuspid regurgitation--> venous [[pulmonary hypertension]]
	*Form of diastolic dysfunction (difficulty filling)		**Ventricular EF typically normal, though systolic function may deteriorate in absence of compensatory hypertrophy
			*If nodal/conduction tissues affected by infiltrative/fibrotic process, may cause SA or [[AV block]]
	*Must distinguish from constrictive [[pericarditis]]		*Must distinguish from constrictive [[pericarditis]]

			==Clinical features==
			*Exertional [[dyspnea]], orthopnea, PND
			*Peripheral edema
			*[[Fatigue]], +/- [[syncope]], [[angina]] from poor cardiac output
			*+/- [[Arrhythmias]], [[AV block]]
			*Quiet precordium
			*Crackles
			*JVD
			*+/- [[murmur]] from mitral/tricuspid regurgitation

	==Differential Diagnosis==		==Differential Diagnosis==
	{{Cardiomyopathy DDX}}		{{Cardiomyopathy DDX}}
	*Restrictive cardiomyopathy ~~ddx~~
			===Restrictive cardiomyopathy etiology DDX===
	**Idiopathic		**Idiopathic
	**Familial ~~noninfiltrative~~ disease		**Familial non=infiltrative disease
	**Infiltrative disease (amyloidosis, sarcoidosis, Gaucher, Hurler)		**Infiltrative disease ([[amyloidosis]], [[sarcoidosis]], Gaucher, Hurler)
	**Storage diseases (~~hemachromatosis~~, Fabry, glycogen/lysosomal storage diseases)		**Storage diseases ([[hemochromatosis]], Fabry, glycogen/lysosomal storage diseases)
	**Diabetes		**[[Diabetes]]
	**Scleroderma		**[[Scleroderma]]
	**Endomyocardial fibrosis (hypereosinophilic syndrome, medication toxicity)		**Endomyocardial fibrosis (hypereosinophilic syndrome, medication toxicity)
	**Radiation, chemotherapy (doxorubicin)		**Radiation, chemotherapy (doxorubicin)
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	==Evaluation==		==Evaluation==
	*Consider if CHF but no evidence of cardiomegaly or systolic dysfunction		*Consider if [[CHF]] but no evidence of cardiomegaly or systolic dysfunction
			*[[ECG]]
			**Typically nonspecific ST/TW abnormalities
			**Other features may include [[low voltage ECG\|low voltage]], [[pathologic Q waves]], [[LVH]], [[AV block]]
			showing ST-segment and T-wave abnormalities
			*[[CXR]]- heart typically normally sized, though can be enlarged in advanced stages of some underlying disease processes
			*[[Echocardiography]]
			**Normal LVEF
			**Elevated LV filling pressures, impaired longitudinal contraction
			**+/- dilated atria, myocardial hypertrophy
			*Definitive diagnosis may require MRI, catheterization, biopsy

	==Management==		==Management==
	*Symptom directed ~~(diuretics and ACEI)~~		*Symptom-directed
			**[[Diuretics]] for edema or pulmonary vascular congestion
			***Caution as cardiac output preload dependant
			**Caution with afterload reduction as may cause profound [[hypotension]]
			**Treat [[arrhythmias]]
			***Avoid [[digoxin]] in amyloidosis as sensitivity to dig-induced arrhythmias common


	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>
			https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/restrictive-cardiomyopathy

	[[Category:Cardiology]]		[[Category:Cardiology]]

ClaireLewis: /* Differential Diagnosis */

2016-09-07T15:53:30Z

Differential Diagnosis

← Revisión anterior		Revisión del 15:53 7 sep 2016
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	**Endomyocardial fibrosis (hypereosinophilic syndrome, medication toxicity)		**Endomyocardial fibrosis (hypereosinophilic syndrome, medication toxicity)
	**Radiation, chemotherapy (doxorubicin)		**Radiation, chemotherapy (doxorubicin)
	**Metastatic disease, carcinoid syndrome		**Metastatic disease, [[carcinoid syndrome]]

	==Evaluation==		==Evaluation==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T00:06:06Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

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	**Metastatic disease, carcinoid syndrome		**Metastatic disease, carcinoid syndrome

	==~~Diagnosis~~==		==Evaluation==
	*Consider if CHF but no evidence of cardiomegaly or systolic dysfunction		*Consider if CHF but no evidence of cardiomegaly or systolic dysfunction

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	==See Also==		==See Also==
	*[[Cardiomyopathy (main)]]		*[[Cardiomyopathy (main)]]
			*[[Constrictive pericarditis]]

	==External Links==		==External Links==