Support
Source? I don’t remember this well enough to comment without reviewing
No source provided so we could reject and ask them to resubmit with source.
BUT I do get why they are asking for this change. I remember when I was first learning this card I would often think hypertrophic first everytime since that’s more common. The extra field even says “hypertrophic cardiomyopathy is also characterized by decreased compliance, secondary to hypertrophy” which doesn’t help.
AMBOSS doesn’t have anything on “without hypertrophy” in this article https://next.amboss.com/us/article/MI0MWh
From the pathophysiology subsection
Infiltration (e.g., abnormal proteins, glycogen, eosinophils, granulomas, iron) or proliferation of connective or fibrotic tissue → ↓ elasticity of myocardium → ↓ ventricular compliance (severe diastolic dysfunction) → ↓ ventricular filling in diastole → ↑ left and right-sided filling pressures → ↑ atrial size → ↑ pulmonary and systemic venous congestion → late-stage ↓ in LV systolic function → hypotension
I propose changing suggestion to:
{{c1::Restrictive}} cardiomyopathy is primarily characterized by decreased compliance of the ventricular endomyocardium secondary to decreased elasticity of the myocardium
with elasticity underlined.
alternate “due to decreased elasticity of the myocardium” but I like using secondary even if longer.
Nothing else would need to be changed as the extra section would already answer why hypertrophic isn’t answer.
Not sure I like this because elasticity and compliance should be inherently linked and actually should be inverse of each other to my understanding (e.g., a less elastic lung is more compliant, like in emphysema + nid:1470850142433 assuming elastance = elasticity).
Maybe instead just simplify to “…secondary to connective/fibrotic tissue proliferation”?
True, I was just trying to make my suggestion as concise as possible to not make it too long, but I do like your suggestion