RT Book, Section
A1 Higgins, John P.
A1 Ali, Asif
A1 Filsoof, David M.
SR Print(0)
ID 1173757648
T1 Cardiac Diseases
T2 Cardiology Clinical Questions, 2e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9781259643330
LK accesscardiology.mhmedical.com/content.aspx?aid=1173757648
RD 2024/04/19
AB Table  Graphic  Jump  Location|Download  (.pdf)|PrintThe  diagnosis  of  amyloid  cardiomyopathy  is  based  on  symptomatology,  echocardiogram  findings,  and  tissue  biopsy.HPI:  Dyspnea,  fatigue,  syncope,  easy  bruising.PMH:  AL  (primary)  amyloidosis.FH:  Familial  amyloidosis.Peripheral  edema,  hepatomegaly,  hypotension,  elevated  jugular  venous  pressure,  periorbital  purpura,  skin  bruising.Low  voltage,  atrial  fibrillation.ECHO:  Granular  sparkling  appearance  of  myocardium,  thickened  left  ventricle,  thickened  and  dilated  right  ventricle,  mitral  and  aortic  valve  leaflet  thickening.AC  =  Amyloid  Cardiomyopathy.SYMP  =  SYMPtoms  of  dyspnea,  fatigue,  and/or  syncope.ECHO  =  ECHOcardiogram  findings  of  granular  sparkling  myocardium,  thickened  left  and  right  ventricular,  mitral  and  aortic  valve  leaflet  thickening.NCARD-BX  =  Non-CARDiac  tissue  and/or  (abdominal  fat  pad,  rectum,  or  kidney)  Biopsy  positive  for  amyloid  deposits.IN-NCARD-BX  =  INconclusive  Non-CARDiac  tissue  Biopsy.CARD-BX  =  EndomyoCARDial  Biopsy  positive  for  amyloid  deposits.SYMP  +  ECHO  +  NCARD-BX  =  ACSYMP  +  ECHO  +  IN-NCARD-BX  +  CARD-BX  =  ACCardiac  amyloidosis  should  be  ruled  out  in  any  patient  with  unexplained  heart  failure  and  increased  wall  thickness  on  echocardiogram,  especially  if  other  clues  are  present,  such  as  nephrotic  syndrome  or  atrial  fibrillation.–  Endomyocardial  biopsy  is  virtually  100%  sensitive  in  amyloid  cardiomyopathy  as  amyloid  will  be  deposited  throughout  the  heart.–  In  patients  with  known  amyloid  deposits  in  other  organs  and  a  history  of  hypertension,  there  may  be  uncertainty  as  to  whether  ventricular  thickening  represents  amyloid  infiltration  or  hypertensive  heart  disease.  In  such  cases,  a  biopsy  may  be  helpful  to  determine  whether  patient  has  AC.1.  Falk  RH.  Diagnosis  and  management  of  the  cardiac  amyloidosis.  Circulation.  2005;112:2047–2060.