Dr. Usman's Cardiology Notes

Restrictive vs Constrictive Cardiomyopathy: A Complete, Clinician-Friendly Comparison Restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) often present with similar clinical features—especially right-sided heart failure with preserved ejection fraction. Yet their underlying pathology, diagnostic clues, and management differ drastically. Distinguishing the two is crucial because RCM is a myocardial disease, while CP is a potentially reversible pericardial disorder. This article provides a crisp, high-yield comparison for clinicians. --- 🔹 1. Definition Restrictive Cardiomyopathy (RCM) A myocardial disorder characterized by stiff, non-compliant ventricles due to infiltration or fibrosis. → Filling is restricted, systolic function usually preserved until late. Constrictive Pericarditis (CP) A pericardial disease in which a thickened, fibrotic, or calcified pericardium limits ventricular expansion. → Ventricles cannot fill normally due to an external shell. --- 🔹 2. Etiol...

Tissue Doppler Imaging (TDI): A quick clinical refresher TDI uses PW Doppler to capture low-frequency, high-amplitude signals from myocardial tissue, allowing us to evaluate longitudinal LV shortening and lengthening with far greater precision than standard Doppler. Spectral TDI: - The S wave represents systolic motion toward the transducer (positive). - The E′ and A′ waves reflect early and late diastolic motion away from the transducer (negative), capturing the biphasic pattern of LV lengthening. Color TDI: 🔴Red indicates myocardial motion toward the probe during systole. 🔵 Blue indicates motion away from the probe during diastole. TDI helps identify subtle systolic and diastolic abnormalities long before changes appear on conventional measurements such as ejection fraction.