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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


Amyloidosis – notice the pink material between the myocytes.


Amyloidosis – Congo Red is very, very positive.


Endomyocardial fibrosis – fibrosis under the endocardium and in the the inner
third of the myocardium.


Endomyocardial fibrosis of a ventricular wall. When extensive, this would cause
restrictive heart failure too.