Sunday, March 15, 2015
Restrictive Cardiomyopathy
Causes :
Amyloidosis
Endomyocardial fibrosis and Endocardial fibroelastosis
Radiotherapy
hemochromatosis
Loeffler’s endocarditis – eosinophilic infiltrate due to invasive helminthiasis
Clinical Features:
Presentation similar to constrictive pericarditis with signs of failure, raised JVP with Kussmaul sign,
Also prone to conduction blocks due to fibrosis
Morphology:
Atrial dilataion due to inadequate ventricular filling
Ventricles are stiff with thick opaque endocardium and valves
Intramural thrombi due to stasis
M/E shows dense fibrosis in endocardial layer
Increased eosinophil infiltration in Loeffler syndrome
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlL8EwR8XEOV1GZHcZc2NuJq4-XTQGABG9AbaPzb4v5YuaHwzkuY3VRHtHeEyTPotjjpdZIfKD-nFOwbsqm3oI6IlZ6Cc9oqJ7j5c8Za4F1ydTSVOoYDdXhxD5332QP78hIsSBcwqbiqY/s320/Amyloidosis+1.png)
Amyloidosis – notice the pink material between the myocytes.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5od7st-JFH7P1hOIVEjLdcgtY0h9LwnzmJ-7Qg7sE0NnpEZLAjdm67vUE9S9lSkZl_kAfg2H4199eDdcNNsH6Bk5rSPKljbYQ6TMlQ0PlqQInw4JDaAiu8GTV1Gqtj27eHKnFMTX08UA/s320/Amyloidosis+%25E2%2580%2593+Congo+Red.png)
Amyloidosis – Congo Red is very, very positive.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNgIOI8R7WXxBPJGCNen3qk7WlEL-MCcREaJsQZh3IjnCeNI8SkZxJhcFnAtPjdj0lWON6ZPl-5WGelOEKj5Ob6VYwEYi2SBunP7XPgLv_2qWhasYAWk-CmoqFVFKyxbMe1Mb8yrR_pdM/s320/Endomyocardial+fibrosis.png)
Endomyocardial fibrosis – fibrosis under the endocardium and in the the inner
third of the myocardium.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKwKcQm6Q8yVpAy6ktdxjDvInspboD8ZXtljklW-oTkinLBszEyrHGMVUc4K_O7Ws9NZQ0tsUuJ8zKx96289wdIvG-UkQv4CXiq17VSVBCi7JMmaSZLTNrlFcRSqkGS3NsPZcdQ9QwIP4/s320/Endomyocardial+fibrosis+of+a+ventricular+wall.png)
Endomyocardial fibrosis of a ventricular wall. When extensive, this would cause
restrictive heart failure too.
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