Henry Ford Hospital Medical Journal


Restrictive obliterative cardiomyopathy, with emphasis on amyloid infiltration of the heart, is discussed. The presence of right-sided failure associated with low-voltage electrocardiographic complexes may simulate constrictive pericarditis. Intractable congestive heart failure is the most frequent presentation of amyloid heart disease, and the average survival from diagnosis is 14 months. Digitalis sensitivity and fatal arrhythmias are notoriously common. Other important, although less common, restrictive cardiomyopathies include 1) hemochromatosis, which is the only reversible cause of heart failure in this group: and 2) endomyocardial fibrosis, which is rarely seen in temperate zones but which is amenable to surgical palliation. Many questions regarding the pathogenesis and management of restrictive myocardial disease remain unanswered.