Restrictive cardiomyopathy is most often caused by which type of process?

Restrictive cardiomyopathy is most often caused by which type of process?

• A. Ischemic
• B. Hypertrophic
• C. Valvular disease
• D. Infiltrative process

Answer: (D)

Restrictive cardiomyopathy arises when the heart becomes stiff and noncompliant, so diastolic filling is impaired while systolic function may stay relatively preserved early on. The most common cause is an infiltrative or fibrotic process that deposits abnormal material or scar within the myocardium, making the ventricles restrictive. Classic examples include amyloidosis, as well as other infiltrative conditions like sarcoidosis or hemochromatosis, and fibrosis from radiation. These processes thickens or stiffens the myocardial tissue from the inside, directly producing the restrictive physiology. Ischemic disease tends to damage the heart through loss of viable myocardium and scar, leading to systolic dysfunction and dilated chambers rather than the diastolic stiffness characteristic of restrictive physiology. Hypertrophic cardiomyopathy involves thickened walls and often outflow tract obstruction, which is a different pathophysiology with its own diastolic dysfunction, not primarily an infiltrative process. Valvular disease can affect filling pressures, but restrictive physiology is most classically driven by tissue infiltration or fibrosis of the myocardium itself.

Restrictive cardiomyopathy arises when the heart becomes stiff and noncompliant, so diastolic filling is impaired while systolic function may stay relatively preserved early on. The most common cause is an infiltrative or fibrotic process that deposits abnormal material or scar within the myocardium, making the ventricles restrictive. Classic examples include amyloidosis, as well as other infiltrative conditions like sarcoidosis or hemochromatosis, and fibrosis from radiation. These processes thickens or stiffens the myocardial tissue from the inside, directly producing the restrictive physiology.

Ischemic disease tends to damage the heart through loss of viable myocardium and scar, leading to systolic dysfunction and dilated chambers rather than the diastolic stiffness characteristic of restrictive physiology. Hypertrophic cardiomyopathy involves thickened walls and often outflow tract obstruction, which is a different pathophysiology with its own diastolic dysfunction, not primarily an infiltrative process. Valvular disease can affect filling pressures, but restrictive physiology is most classically driven by tissue infiltration or fibrosis of the myocardium itself.