Cardiac amyloidosis physical examination
Cardiac amyloidosis Microchapters
Cardiac amyloidosis physical examination On the Web
American Roentgen Ray Society Images of Cardiac amyloidosis physical examination
Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. ; Aarti Narayan, M.B.B.S ; Cafer Zorkun, M.D., Ph.D. ; Lakshmi Gopalakrishnan, M.B.B.S. 
Cardiac amyloidosis is difficult to diagnose. More than 50% of the patients with cardiac amyloidosis present with signs and symptoms suggestive of right heart failure. Common physical exam findings include elevated jugular venous pressure, third heart sound and pedal edema.
The blood pressure may be low or may drop when rising to a standing position (orthostatic hypotension). Orthostatic hypotension is typically observed among patients with kidney involvement. Low cardiac output and/or inappropriate peripheral vasodilation can also contribute to hypotension.
Head and Neck
- Elevated jugular pressure
- Periorbital purpura: Often occurs with sneezing, coughing or with minor trauma. Indicates capillary involvement of AL type amyloidosis.
- Abnormal phonation
- Third heart sound
- Fourth heart sound
- Arrhythmias 
- Auscultation may also reveal rales, heart murmurs, and/or other pathologic heart sounds.
- In patients with valvular heart disease involvement, murmurs of mitral and tricuspid regurgitation may be heard.
- Rapezzi C, Perugini E, Salvi F, Grigioni F, Riva L, Cooke RM, Ferlini A, Rimessi P, Bacchi-Reggiani L, Ciliberti P, Pastorelli F, Leone O, Bartolomei I, Pinna AD, Arpesella G, Branzi A (2006). "Phenotypic and genotypic heterogeneity in transthyretin-related cardiac amyloidosis: towards tailoring of therapeutic strategies?". Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis. 13 (3): 143–53. doi:10.1080/13506120600877136. PMID 17062380. Retrieved 2012-02-13. Unknown parameter