Restrictive Cardiomyopathy

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

Example ECGs

ECG low QRS voltage

Related Topics


LITFL Further Reading

Advanced Reading




Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |

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