A stiff heart, often referring to a condition called restrictive cardiomyopathy, describes a heart that has difficulty relaxing and filling with blood between heartbeats.
Understanding a Stiff Heart
Instead of the heart muscle being pliable and able to stretch to accommodate blood, it becomes rigid and inflexible. This stiffness impedes the heart's ability to pump blood efficiently, leading to a backup of blood and fluid in other parts of the body. Cardiac amyloidosis is a common cause of a stiff heart.
Causes of a Stiff Heart
Several factors can cause the heart muscle to stiffen, including:
- Cardiac Amyloidosis: As referenced, this is a primary cause where abnormal protein deposits (amyloid) infiltrate the heart tissue, making it stiff.
- Sarcoidosis: An inflammatory disease that can affect multiple organs, including the heart, causing inflammation and stiffness.
- Hemochromatosis: A condition where the body absorbs too much iron, which can accumulate in the heart and damage the muscle.
- Scarring After Heart Surgery or Radiation: Previous heart procedures or radiation therapy can sometimes lead to scarring and stiffening of the heart muscle.
- Idiopathic Restrictive Cardiomyopathy: In some cases, the cause of the stiff heart remains unknown.
Effects of a Stiff Heart
The reduced ability of the heart to fill properly leads to several symptoms and complications:
- Shortness of Breath: Fluid buildup in the lungs makes breathing difficult, especially during exertion.
- Swelling in the Legs and Ankles (Edema): Fluid retention due to poor circulation.
- Fatigue: The heart's inability to pump blood efficiently leads to reduced oxygen delivery to the body.
- Arrhythmias: Irregular heartbeats can occur due to the disruption of the heart's electrical system.
- Heart Failure: The stiff heart cannot meet the body's demands for blood, leading to heart failure.
Diagnosis and Treatment
Diagnosing a stiff heart involves a thorough medical history, physical examination, and diagnostic tests such as:
- Echocardiogram: Ultrasound of the heart to assess its structure and function.
- Electrocardiogram (ECG): Records the electrical activity of the heart.
- Cardiac MRI: Provides detailed images of the heart.
- Cardiac Biopsy: A small sample of heart tissue is taken for examination under a microscope.
Treatment focuses on managing symptoms and addressing the underlying cause. This may include:
- Medications: Diuretics to reduce fluid buildup, medications to control heart rate and rhythm, and medications to treat the underlying cause (e.g., chemotherapy for cardiac amyloidosis).
- Lifestyle Changes: Dietary modifications (low-sodium diet), exercise restrictions, and weight management.
- Implantable Devices: Pacemakers or implantable cardioverter-defibrillators (ICDs) may be needed to manage arrhythmias.
- Heart Transplant: In severe cases, a heart transplant may be considered.
