Presentation and Physical examination of RCM:
>The diagnosis of restrictive cardiomyopathy should be considered in a patient presenting with heart failure, but no evidence of cardiomegaly or systolic dysfunction.
>Usually, patients present with fatigue and dyspnoea. Angina does not occur, except in amyloidosis in which it may be the presenting symptom.
>Patients may also present with thromboembolic complications.
>Cardiac conduction disturbances and AF are particularly common in idiopathic restrictive cardiomyopathy and amyloidosis.
>Heart block and ventricular arrhythmias are also common in cardiac sarcoidosis.
>JVP is elevated.
>Kussmaul’s sign , i.e. a rise or failure of JVP to decrease with inspiration.
>S3 of LV or RV origin may be present.
>Peripheral oedema or ascites and enlarged and pulsatile liver may be seen in progressed disease.