What lifestyle modifications and pharmacological treatments are recommended for patients diagnosed with restrictive cardiomyopathy?

Lifestyle modifications for patients with restrictive cardiomyopathy primarily focus on symptom management and preventing complications. These include fluid and salt restriction to reduce fluid overload and congestion, regular monitoring of weight and symptoms to detect worsening heart failure early, and avoiding strenuous physical activity that may exacerbate symptoms. Patients should also be advised to manage comorbidities such as hypertension and diabetes optimally.

Pharmacological treatments aim to relieve symptoms of heart failure and manage associated conditions. Diuretics are routinely used to relieve congestive symptoms and fluid retention and should be titrated according to need, especially in heart failure with preserved ejection fraction, which is common in restrictive cardiomyopathy ². Cautious use of low to medium doses of loop diuretics (e.g., furosemide less than 80 mg/day) is recommended to control volume overload ².

Other heart failure medications such as ACE inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, and mineralocorticoid receptor antagonists may be considered based on individual patient tolerance and comorbidities, but their benefit in restrictive cardiomyopathy is less well established and should be guided by specialist advice ². Digoxin may be used cautiously in cases with atrial fibrillation or worsening heart failure symptoms, but specialist consultation is advised before initiation ².

Management of arrhythmias and anticoagulation should be tailored individually, often requiring specialist input. There is no specific pharmacological treatment that reverses restrictive cardiomyopathy; thus, treatment is largely supportive and symptom-directed ².