Cardiac amyloidosis echocardiography: Difference between revisions

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==Overview==
==Overview==
[[Transthoracic echocardiography]] is most commonly used in the initial evaluation of cardiac amyloidosis. The most common echocardiographic finding is thickening of the [[left ventricle]].  Echocardiographic findings strongly correlate with the degree of cardiac dysfunction and disease progression with mildly or moderately increased wall thickness in the early asymptomatic phase and severe thickening and hypokinesia of the left ventricular posterior wall and interventricular septum in clinically apparent cardiac dysfunction.
[[Transthoracic echocardiography]] is most commonly used in the initial evaluation of cardiac amyloidosis. The most common echocardiographic finding is thickening of the [[left ventricle]].  Echocardiographic findings strongly correlate with the degree of cardiac dysfunction and disease progression with mildly or moderately increased wall thickness in the early asymptomatic phase and severe thickening and [[hypokinesia]] of the left ventricular posterior wall and [[interventricular septum]] in clinically apparent [[cardiac dysfunction]].


==Echocardiography==
==Echocardiography==

Revision as of 17:53, 4 May 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]: Aarti Narayan, M.B.B.S [3]; Cafer Zorkun, M.D., Ph.D. [4]

Overview

Transthoracic echocardiography is most commonly used in the initial evaluation of cardiac amyloidosis. The most common echocardiographic finding is thickening of the left ventricle. Echocardiographic findings strongly correlate with the degree of cardiac dysfunction and disease progression with mildly or moderately increased wall thickness in the early asymptomatic phase and severe thickening and hypokinesia of the left ventricular posterior wall and interventricular septum in clinically apparent cardiac dysfunction.

Echocardiography

Findings on echocardiography include:[1][2][3]

  • Thickening of the left ventricle
  • Granular or sparkling appearance of the myocardium secondary to amyloid deposition in the myocardium. This finding is especially seen best with two dimentional echocardiography as hyperrefractile myocardial echoes.
  • Thickening of interventricular septum
  • Diastolic dysfunction
  • Normal or reduced LV cavity
  • Pericardial effusion
  • RV hypertrophy
  • Left atrial enlargement
  • Thickened AV valves
  • Right ventricular dilatation (poor prognostic marker indicating right heart failure)

The combination of increased thickness of the left ventricular posterior wall and interventricular septum with a low voltage electrocardiographic pattern is highly specific for cardiac amyloidosis. In an echocardiographic study conducted in 54 patients (30 with AA type cardiac amyloidosis and 24 with AL type amyloidosis) it was found that this finding is more often seen in the AL type cardiac amyloidosis.

References

  1. Siqueira-Filho AG, Cunha CL, Tajik AJ, Seward JB, Schattenberg TT, Giuliani ER (1981). "M-mode and two-dimensional echocardiographic features in cardiac amyloidosis". Circulation. 63 (1): 188–96. PMID 7438392. Unknown parameter |month= ignored (help)
  2. Nishikawa H, Nishiyama S, Nishimura S; et al. (1988). "Echocardiographic findings in nine patients with cardiac amyloidosis: their correlation with necropsy findings". Journal of Cardiology. 18 (1): 121–33. PMID 3221306. Unknown parameter |month= ignored (help)
  3. Hamer JP, Janssen S, van Rijswijk MH, Lie KI (1992). "Amyloid cardiomyopathy in systemic non-hereditary amyloidosis. Clinical, echocardiographic and electrocardiographic findings in 30 patients with AA and 24 patients with AL amyloidosis". European Heart Journal. 13 (5): 623–7. PMID 1618203. Unknown parameter |month= ignored (help)


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