The common hemodynamic disturbance is impairment of ventricular filling due to the thickening and increased rigidity of the endocardium and myocardium secondary to infiltration by amyloid tissue or by fibrosis. Systolic function remains normal or near normal until late stages. EMF may account for up to one fourth of deaths due to cardiac disease in those areas. Adults experience a prolonged course of heart failure and may have complications of cardiac cirrhosis and thromboembolism. Patients who are refractory to supportive therapy usually die of low-output cardiac failure unless cardiac transplantation is an option.
Patients often present at an advanced stage of disease with pronounced cardiopulmonary symptoms.
However, secondary infiltrative myocardial diseases, which are actually cardiac manifestations of systemic diseases, often are grouped together with cardiomyopathies. An elevated eosinophil count may indicate eosinophilic endomyocardial disease. ED care is symptom directed. Cardiology consultation is suggested in order to optimize management and establish a definitive diagnosis. As mentioned above, treatment of restrictive cardiomyopathy is symptomatic.