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.