Restrictive cardiomyopathy: The Daily PANCE Blueprint

The answer is C. Amyloidosis

Restrictive heart disease is most commonly caused by amyloidosis, but can also be caused by radiation, sarcoidosis, scleroderma, and hemochromatosis. The restrictive cardiomyopathy decreases compliance of the ventricles and impairs diastolic filling, leading to congestion/backflow of blood back into the lungs and body. The presenting symptoms are often fatigue and exercise intolerance. On physical exam, you may see signs of pulmonary and systemic congestion (weak pulses, peripheral edema, pulmonary crackles, ascites, JVD, etc). EKG findings are often non-specific (LAE, low-voltage QRS, AV block, etc). Work-up includes TTE and cardiac MRI. The definitive diagnosis would be an endomyocardial biopsy.