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 CARDIOMYOPATHY-3
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Diagnosis
A physician may suspect restrictive cardiomyopathy based on a patient's symptoms and the presence of another disease. Although symptoms of congestive heart failure may predominate, the size of the heart remains relatively small, unlike other cardiomyopathies.
Diagnostic information comes from an electrocardiogram or any of several imaging studies that provide pictures of the heart. These include echocardiography, magnetic resonance imaging, and computed tomography.
A definite diagnosis usually requires cardiac catheterization studies or a biopsy, in which a tiny piece of tissue--including heart muscle--is removed for laboratory analysis.
Treatment
Restrictive cardiomyopathy has no specific treatment. The underlying disease that leads to the heart problem also may not be treatable.
In general, the use of traditional heart drugs has been limited in this cardiomyopathy, although diuretics may help control fluid accumulation.
In rare cases, surgery is sometimes used to try to improve blood flow into the heart.
Course of the disease
The condition is similar to dilated cardiomyopathy and tends to worsen with time. Only about 30 percent of patients survive more than 5 years after diagnosis.

statin problems
FUTURE DIRECTIONS
Future advances in the diagnosis and treatment of cardiomyopathy depend on a better understanding of the disease process and why heart muscle is damaged. A lot of research is under way to identify these processes and whether they can be halted or even reversed. Much of the research is conducted at or supported by the National Heart, Lung, and Blood Institute (NHLBI).
Promising clues came from investigators at and supported by the NHLBI who discovered some of the genes responsible for hypertrophic cardiomyopathy. Their work represents an important first step in understanding how the disease is transmitted and how it progresses.
Researchers also are trying to determine the best use of currently available treatments, especially drug therapies. Drugs useful for other conditions may help treat cardiomyopathy. For example, drugs effective in treating high blood pressure also help manage heart failure and irregular heartbeats.
Additionally, much work has been--and continues to be--done on identifying factors that increase or decrease the risk of death for persons with cardiomyopathy. Knowing which patients are at the greatest risk is very important in determining the best approach to evaluation and treatment of their condition.
The development of improved treatments for cardiomyopathy, however, awaits still more research and a better understanding of the disease process.

GLOSSARY
Angiotensin converting enzyme (ACE) inhibitor--A drug used to decrease pressure inside blood vessels.
Arrhythmia--An irregular heartbeat.
Beta blocker--A drug used to slow the heart rate and reduce pressure inside blood vessels. It also can regulate heart rhythm.
Calcium channel blocker (or calcium blocker)--A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm.
Cardiac arrest--A sudden stop of heart function. See also "sudden death."
Cardiac catheterization--A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity.
Cardiomyopathy--A disease of the heart muscle (myocardium).
Congestion--Abnormal fluid accumulation in the body, especially the lungs.
Digitalis--A drug used to increase the force of the heart's contraction and to regulate specific irregularities of heart rhythm.
Dilated cardiomyopathy--Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability.
Diuretic--A drug that helps eliminate excess body fluid; usually used in the treatment of high blood pressure and heart failure.
Dyspnea--Shortness of breath.
Echocardiography--A test that bounces sound waves off the heart to produce pictures of its internal structures.
Edema--Abnormal fluid accumulation in body tissues.
Electrocardiogram (EKG or ECG)--Measurement of electrical activity during heartbeats.
Heart failure--Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues.
Hypertrophic cardiomyopathy--Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood.
Idiopathic--Results from an unknown cause.

Left ventricular assist device (LVAD)--A mechanical device used to increase the heart's pumping ability.
Pulmonary congestion (or edema)--Fluid accumulation in the lungs.
Restrictive cardiomyopathy--Heart muscle disease in which the muscle walls become stiff and lose their flexibility.

Septum--In the heart, a muscle wall separating the chambers.

Sudden death--Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive.



Ventricles--The two lower chambers of the heart. The left ventricle is the main pumping chamber in the heart. Ventricular fibrillation--Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat.