5th July 2026

A 58-year-old woman with RCM presents with worsening dyspnoea and severe diastolic dysfunction.

A 58-year-old woman with RCM presents with worsening dyspnoea and severe diastolic dysfunction. You see in her record she has had recurrent hospitalisations despite optimised medical therapy, including advanced diuretics, beta-blockers, and ACE inhibitors. She remains in NYHA class IV heart failure, and cardiac catheterisation shows normal coronary arteries and elevated pulmonary capillary wedge pressures. Her echocardiogram reveals no improvement in diastolic dysfunction. What is the most appropriate next step in the management of this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.