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There is no effective treatment for restrictive cardiomyopathy. Treatment of a causative disease may reduce or stop the damage to the heart, but existing damage cannot be reversed. Medications may be used to lessen the workload on the heart and to control the heart rhythm. Drugs normally used to treat other types of cardiomyopathy and heart failure may cause problems for patients with restrictive cardiomyopathy. For example, medicines that reduce the heart’s workload may lower blood pressure too much. A heart transplant may be necessary for patients who develop severe heart failure.

Obtaining early treatment for diseases that might cause restrictive cardiomyopathy might prevent or slow the development of heart wall stiffness. Anyone experiencing symptoms of shortness of breath, tiredness, and weakness should see a physician.

Doctors may be able to treat the condition that is causing restrictive cardiomyopathy, but the heart problem itself generally cannot be reversed. Doctors currently have no way of repairing severely damaged heart muscle. So the treatment goal is mainly controlling the symptoms of restrictive cardiomyopathy. Medicines are sometimes used to ease the heart’s workload and to keep a regular heart rhythm. When the condition becomes severe, a heart transplant may be needed.

In most cases, restrictive cardiomyopathy is a progressive disease in which the cause of the disease is not known (idiopathic restrictive cardiomyopathy) and so cannot be directly treated. Typically, the heart muscle continues to stiffen and lose function and strength, and heart failure (inability of the heart to pump enough blood) develops. In these cases, treatment involves trying to decrease the heart’s workload.

In some cases the cause of restrictive cardiomyopathy can be identified, such as in carcinoid syndrome, sarcoidosis, and amyloidosis, although the treatment is generally ineffective. Corticosteroids may offer limited benefit in treating sarcoidosis and amyloidosis. In most of these cases, the condition is progressive, and treatment involves trying to manage heart failure symptoms.

But in other cases where the cause is diagnosed early and can be treated, further heart damage may be prevented. For example, in restrictive cardiomyopathy caused by hemochromatosis (a buildup of iron in the heart muscle), treatment may involve the use of drugs that help eliminate excess iron (chelating agents) and/or phlebotomy (withdrawing blood). In another example, an inherited problem called Fabry’s disease can be treated to prevent restrictive cardiomyopathy from happening.

If heart failure has developed, your doctor will prescribe medicines to manage its symptoms and complications. They may include:

1.Calcium channel blockers, which slow your heart rate and lower blood pressure. These medicines may be used to treat diastolic heart failure, when the heart has problems filling with blood.
2.Digoxin, which can help increase the strength of heart contractions. These medicines are sometimes used, although with caution in those people who have amyloidosis, because they can lead to serious arrhythmias.
3.Anticoagulants, to help prevent blood clots from forming in the heart. People with restrictive cardiomyopathy, especially those with atrial fibrillation, are at risk for developing clots, which can travel through the bloodstream to other places in the body and cause a heart attack, pulmonary embolism, or stroke.
4.Beta-blockers, which slow the heart rate and reduce blood pressure.
5.Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) to improve blood flow and reduce the heart’s workload. ARBs may be used when a person cannot tolerate ACE inhibitors or when ACE inhibitors are not controlling symptoms.
6.Diuretics, which help eliminate fluid buildup in the lungs and elsewhere in the body.

Surgery

An artificial pacemaker may be surgically placed in the chest. Scar tissue that develops in restrictive cardiomyopathy may block electrical impulses traveling through the heart and result in abnormal heartbeats, called arrhythmias. Pacemakers stimulate the heart muscle to beat regularly when the electrical signals from the top of the heart are blocked.

An implantable cardioverter-defibrillator (ICD) is another small device that may be surgically placed in the chest. It is used to lower the risk of sudden death from life-threatening irregular heart rhythms (arrhythmias). An ICD continuously monitors your heart. If it detects a life-threatening rapid heart rhythm, it sends an electric shock to your heart to restore a normal rhythm. You may need an ICD if you have had a serious episode of life-threatening irregular heart rhythm or are at high risk for having one.

A heart transplant is available to a small number of people who have severe end-stage restrictive cardiomyopathy and who meet specific criteria for transplantation. The diseased heart is removed and replaced with a healthy heart donated by a person who has recently died. There are limited donor hearts available.

Stem cell transplantation may be used for amyloidosis (a buildup of protein), although the long-term benefits are not known.

When the cause of any cardiomyopathy can be found, that condition is treated.

Few treatments are known to be effective for restrictive cardiomyopathy. The main goal of treatment is to control symptoms and improve quality of life.

The following treatments may be used to control symptoms or prevent problems:

1.Steroids for specific causes.
2.Medications to prevent or control irregular or abnormal heart rhythms.
3.Diuretics to remove fluid and help improve breathing.
4.Chemotherapy (in some situations).
5.Blood thinning medications, either aspirin or warfarin.

A heart transplantheart transplant may be considered if the heart function is very poor and the patient has many symptoms.