Restrictive cardiomyopathy in older adults may lead to heart failure or arrhythmia

Restrictive cardiomyopathy in older adults may lead to heart failure or arrhythmia. A condition characterized by abnormal heart muscle, cardiomyopathy comes in different types: restrictive, dilated, and hypertrophic.

Restrictive cardiomyopathy is most common in seniors, but it is, in fact, quite rare. In this condition, the heart’s ventricles become rigid because the normal heart muscle is replaced with abnormal tissue. As a result, the ventricles are unable to relax and fill with blood, and the atria become enlarged. Over time, this results in a decreased blood flow in the heart, contributing to heart failure or arrhythmia.

Restrictive cardiomyopathy causes and complications

In restrictive cardiomyopathy, the heart can pump normally, but is unable to relax in-between the heart beats. As the disease progresses, the heart becomes weaker and is no longer able to pump blood strongly. This abnormal heart function can affect all organs in the body, as they require blood flow.

The most common cause of restrictive cardiomyopathy is amyloidosis and scarring of the heart due to an unknown cause. Restrictive cardiomyopathy can also develop after a heart surgery.

Other causes include:

• Carcinoid heart disease
• Diseases of the heart lining
• Iron overload
• Sarcoidosis
• Scarring after radiation or chemotherapy
• Scleroderma
• Tumors of the heart

Complications resulting from restrictive cardiomyopathy include heart failure, stroke, abnormal heart rhythm, increased risk of complications during pregnancy, and sudden cardiac death.

Restrictive cardiomyopathy symptoms

Symptoms of restrictive cardiomyopathy are similar to those of heart failure. Ranging from mild to severe, they can develop gradually over time or occur suddenly. Symptoms of cardiomyopathy include:

• Cough
• Breathing difficulties, especially at night or when laying down
• Fatigue
• Loss of appetite
• Swelling of the abdomen
• Swelling of the feet or ankles
• Uneven or rapid pulse
• Chest pain
• Inability to concentrate
• Low urine output
• Nocturia (nighttime urination)

Diagnosis and tests for restrictive cardiomyopathy

During a physical examination, your doctor will look for enlarged or bulging neck veins, enlarged liver, lung crackles or abnormal breathing, fluid backup of the hands or feet, and other signs of heart failure.

Tests to properly diagnose restrictive cardiomyopathy include chest CT scan, chest X-ray, ECG, echocardiogram, MRI of the heart, nuclear heart scan, serum iron studies, serum or urine protein tests, or cardiac catheterization. A biopsy of the heart may also be taken, but this is not a common practice.

Restrictive cardiomyopathy treatment

Effective treatment options for restrictive cardiomyopathy are very limited, so the main goal is to ease symptoms as much as possible. Treatments for restrictive cardiomyopathy include blood thinning medications, chemotherapy, diuretics to remove excess fluid buildup, medicines to prevent or control irregular heartbeat, and steroids.

If heart function is poor, your doctor may recommend a heart transplant.

The outlook of restrictive cardiomyopathy is not very positive, though it often depends on the cause of the condition. Survival after diagnosis may go beyond 10 years.

Related: Why your heart skips a beat