Restrictive Cardiomyopathy Overview
- Restrictive cardiomyopathy is the least common form of cardiomyopathy.
- It occurs in the advanced stages of myocardial infiltrative disease — e.g. due to haemochromatosis, amyloidosis or sarcoidosis.
- Diffuse myocardial infiltration leads to low voltage QRS complexes.
- Atrial fibrillation may occur due to atrial enlargement; ventricular arrhythmias are also common.
- Infiltration of the cardiac conducting system (e.g. due to septal granuloma formation in sarcoidosis) may lead to conduction disturbance — e.g. bundle branch blocks and AV block.
- Healing granulomas in sarcoidosis may produce “pseudo-infarction” Q waves.
ECG Features of Restrictive Cardiomyopathy
- Low voltage QRS complexes
- Non-specific ST segment / T wave changes
- Bundle branch blocks
- Atrioventricular block (3rd degree AV block may occur in sarcoidosis)
- Pathological Q waves
- Atrial and ventricular dysrhythmias
- Brady WJ, Truwit JD. Critical Decisions in Emergency and Acute Care Electrocardiography
- Hampton, JR. The ECG In Practice, 6e
- Surawicz B, Knilans T. Chou’s Electrocardiography in Clinical Practice: Adult and Pediatric, 6e
- Wagner, GS. Marriott’s Practical Electrocardiography 12e
- Chan, TC. ECG in Emergency Medicine and Acute Care
- Mattu, A. ECG’s for the Emergency Physician
LITFL Further Reading
- ECG BASICS — Waves, Intervals, Segments and Clinical Interpretation
- ECG A to Z by diagnosis –alphabetical diagnostic approach to the ECG
- ECG CLINICAL CASES — ECG’s placed in clinical context with a challenging Q&A approach
- 100 ECG Quiz — Self-assessment tool for examination practice
- ECG Reference SITES and BOOKS — the best of the rest
- LITFL ECG IMAGE Database — Searchable database of LITFL ECG’s
- ECG and Cardiology Eponymous Syndromes — Cheats guide to eponymous emancipation
- ECG Exam Template — a framework for answering ECG exam questions.