Symptoms:

Symptoms of heart failure are most common. Usually, these symptoms develop slowly over time. However, sometimes symptoms start very suddenly and are severe.

Common symptoms are:

• Cough
• Difficulty breathing
  • At night
  • Especially with exertion
  • When lying flat
• Fatigue, poor exercise tolerance
• Irregular or rapid pulse
• Loss of appetite
• Swelling of the abdomen
• Swelling of the feet and ankles

Other symptoms may include:

• Chest pain
• Decreased alertness or concentration
• Failure to thrive (in children)
• Low urine production
• Need to urinate at night (in adults)
• Shock (low blood pressure)

Signs and tests:

An examination may show:

• Enlarged (distended) or bulging neck veins
• Enlarged liver
• Lung crackles and abnormal or distant heart sounds when listening to the chest with a stethoscope (auscultation)
• Fluid backup into the hands and feet
• Signs of heart failure

Children will have:

• Difficulty feeding
• Pale skin
• Poor growth
• Weak pulses in the legs and arms

Tests for restrictive cardiomyopathy include:

• Cardiac catheterization and coronary angiography
• Chest CT scan
• Chest x-ray
• ECG (electrocardiogram)
• Echocardiogram and Doppler study
• MRI of the heart
• Nuclear heart scan (MUGA, RNV)
• Serum iron studies

Restrictive cardiomyopathy may be hard to tell apart from constrictive pericarditis. A biopsy of the heart muscle or cardiac catheterization may help confirm the diagnosis.