Cardiac amyloidosis electrocardiogram: Difference between revisions

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==Overview==
==Overview==
The combination of low voltage electrocardiographic pattern and increased thickness of the left ventricular posterior wall and interventricular septum on echocardiogram is highly specific for cardiac amyloidosis. Conduction and rhythm disturbances are common in cardiac amyloidosis, however direct infiltration of the specialized conduction tissue of the heart by the amyloid does not account for the majority of these disturbances.
The combination of [[low voltage electrocardiographic pattern]] and increased thickness of the [[Left ventricle|left ventricular]] [[Anatomical terms of location|posterior]] wall and [[interventricular septum]] on [[Echocardiography|echocardiogram]] is highly [[Specificity|specific]] for cardiac amyloidosis. [[Heart|Cardiac]] conduction and [[rhythm]] disturbances are common in cardiac amyloidosis, however, direct infiltration of the specialized conduction [[Tissue (biology)|tissue]] of the [[heart]] by the [[amyloid]] may not account for the majority of these disturbances.


==Electrocardiogram==
==Electrocardiogram==
Electrocardiographic findings in cardiac amyloidosis incluse:<ref name="pmid871125">{{cite journal |author=Ridolfi RL, Bulkley BH, Hutchins GM |title=The conduction system in cardiac amyloidosis. Clinical and pathologic features of 23 patients |journal=[[The American Journal of Medicine]] |volume=62 |issue=5 |pages=677–86 |year=1977 |month=May |pmid=871125 |doi= |url=}}</ref><ref name="pmid15013123">{{cite journal |author=Rahman JE, Helou EF, Gelzer-Bell R, ''et al.'' |title=Noninvasive diagnosis of biopsy-proven cardiac amyloidosis |journal=[[Journal of the American College of Cardiology]] |volume=43 |issue=3 |pages=410–5 |year=2004 |month=February |pmid=15013123 |doi=10.1016/j.jacc.2003.08.043 |url=}}</ref><ref name="pmid15695149">{{cite journal |author=Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M |title=Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement |journal=[[The American Journal of Cardiology]] |volume=95 |issue=4 |pages=535–7 |year=2005 |month=February |pmid=15695149 |doi=10.1016/j.amjcard.2004.10.028 |url=}}</ref>
ECG findings in cardiac amyloidosis include:<ref name="pmid871125">{{cite journal |author=Ridolfi RL, Bulkley BH, Hutchins GM |title=The conduction system in cardiac amyloidosis. Clinical and pathologic features of 23 patients |journal=[[The American Journal of Medicine]] |volume=62 |issue=5 |pages=677–86 |year=1977 |month=May |pmid=871125 |doi= |url=}}</ref><ref name="pmid15013123">{{cite journal |author=Rahman JE, Helou EF, Gelzer-Bell R, ''et al.'' |title=Noninvasive diagnosis of biopsy-proven cardiac amyloidosis |journal=[[Journal of the American College of Cardiology]] |volume=43 |issue=3 |pages=410–5 |year=2004 |month=February |pmid=15013123 |doi=10.1016/j.jacc.2003.08.043 |url=}}</ref><ref name="pmid15695149">{{cite journal |author=Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M |title=Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement |journal=[[The American Journal of Cardiology]] |volume=95 |issue=4 |pages=535–7 |year=2005 |month=February |pmid=15695149 |doi=10.1016/j.amjcard.2004.10.028 |url=}}</ref>
* Low voltage complexes
* [[Low voltage complexes]]
* Pseudo-infarct pattern (poor [[R wave]] progression)
* [[Pseudo-infarct pattern]] of [[poor R wave progression]]
* Left ventricular hypertrophy pattern
* [[Left ventricular hypertrophy on electrocardiogram|Left ventricular hypertrophy]]
* Higher degree AV blocks
* Higher degree [[AV block]]s
* AV nodal slowing
* [[Bundle branch block]]s: [[Left bundle branch block]] is seen in 40% of the [[Patient|patients]] with wild-type ATTR versus 4% of those with [[AL amyloid type]].
*[[Arrhythmia]]s such as  
*[[Atrioventricular node|AV nodal]] slowing of [[heart rate]]
** [[Atrial fibrillation]]
* [[Arrhythmia]]s, such as  
**[[Atrial fibrillation]]
** [[Atrial flutter]]
** [[Atrial flutter]]
** [[Ventricular tachycardia]]
** [[Ventricular tachycardia]]
** [[Premature ventricular contractions]]
** [[Premature ventricular contractions]]
Lack of variability in heart rate due to [[autonomic dysfunction]] can be found on Holter monitoring and also it is an important predictor of 1-year mortality.<ref name="pmid11785998">{{cite journal |author=Reyners AK, Hazenberg BP, Reitsma WD, Smit AJ |title=Heart rate variability as a predictor of mortality in patients with AA and AL amyloidosis |journal=[[European Heart Journal]] |volume=23 |issue=2 |pages=157–61 |year=2002 |month=January |pmid=11785998 |doi=10.1053/euhj.2001.2972 |url=}}</ref>


==References==
==References==
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{{reflist|2}}
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Latest revision as of 20:20, 5 February 2020

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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

The combination of low voltage electrocardiographic pattern and increased thickness of the left ventricular posterior wall and interventricular septum on echocardiogram is highly specific for cardiac amyloidosis. Cardiac conduction and rhythm disturbances are common in cardiac amyloidosis, however, direct infiltration of the specialized conduction tissue of the heart by the amyloid may not account for the majority of these disturbances.

Electrocardiogram

ECG findings in cardiac amyloidosis include:[1][2][3]

References

  1. Ridolfi RL, Bulkley BH, Hutchins GM (1977). "The conduction system in cardiac amyloidosis. Clinical and pathologic features of 23 patients". The American Journal of Medicine. 62 (5): 677–86. PMID 871125. Unknown parameter |month= ignored (help)
  2. Rahman JE, Helou EF, Gelzer-Bell R; et al. (2004). "Noninvasive diagnosis of biopsy-proven cardiac amyloidosis". Journal of the American College of Cardiology. 43 (3): 410–5. doi:10.1016/j.jacc.2003.08.043. PMID 15013123. Unknown parameter |month= ignored (help)
  3. Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M (2005). "Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement". The American Journal of Cardiology. 95 (4): 535–7. doi:10.1016/j.amjcard.2004.10.028. PMID 15695149. Unknown parameter |month= ignored (help)


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