Wild-type (senile) amyloidosis electrocardiogram: Difference between revisions
Jump to navigation
Jump to search
(Created page with "__NOTOC__ {{Wild-type (senile) amyloidosis}} {{CMG}} ==Overview== ==Electrocardiogram== ==References== {{Reflist|2}} Category:Disease Category:Cardiology Categor...") |
Aditya Ganti (talk | contribs) |
||
Line 6: | Line 6: | ||
==Electrocardiogram== | ==Electrocardiogram== | ||
* EKG is one of the oldest, best described and most widely used cardiac diagnostic modalities worldwide. However, its use as diagnostic tool for ATTRwt-CA has likely lead to falsely reduced clinical suspicion and its underdiagnoses of the disease. | |||
* This is largely from the “classical” teaching which dictates that cardiac amyloidosis is associated with low voltage (defined as ≤5 mV amplitude in the limb leads or ≤10 mV amplitude in the precordial leads) despite the presence of LVH and comes from studies of AL amyloid. | |||
* In recent ATTRwt-CA studies, low voltage has been found to have poor independent sensitivity (~30%) for its diagnosis. | |||
* There are numerous other EKG findings that are seen in patients with ATTRwt-CA but have low sensitivity and specificity for the disease because they are also common in age and comorbidities matched patient cohorts: | |||
** Pseudoinfarct pattern | |||
** Poor R-wave progression ( | |||
** Atrial fibrillation | |||
** First degree AV block | |||
** Nonspecific ST-T-wave abnormalities | |||
** Left bundle branch block can be potentially useful to differentiate ATTRwt-CA and AL-CA. | |||
* Voltage-to-mass ratio, calculated by sum of S wave in lead V1 plus R wave in lead V5 or V6 (SV1 + RV5 or V6) divided by the echocardiographic muscle cross-sectional area has been shown to have high sensitivity and specificity for ATTRwt-CA. | |||
==References== | ==References== |
Revision as of 15:11, 5 November 2019
Wild-type (senile) amyloidosis Microchapters |
Differentiating Wild-type (senile) amyloidosis from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Wild-type (senile) amyloidosis electrocardiogram On the Web |
American Roentgen Ray Society Images of Wild-type (senile) amyloidosis electrocardiogram |
Wild-type (senile) amyloidosis electrocardiogram in the news |
Risk calculators and risk factors for Wild-type (senile) amyloidosis electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Electrocardiogram
- EKG is one of the oldest, best described and most widely used cardiac diagnostic modalities worldwide. However, its use as diagnostic tool for ATTRwt-CA has likely lead to falsely reduced clinical suspicion and its underdiagnoses of the disease.
- This is largely from the “classical” teaching which dictates that cardiac amyloidosis is associated with low voltage (defined as ≤5 mV amplitude in the limb leads or ≤10 mV amplitude in the precordial leads) despite the presence of LVH and comes from studies of AL amyloid.
- In recent ATTRwt-CA studies, low voltage has been found to have poor independent sensitivity (~30%) for its diagnosis.
- There are numerous other EKG findings that are seen in patients with ATTRwt-CA but have low sensitivity and specificity for the disease because they are also common in age and comorbidities matched patient cohorts:
- Pseudoinfarct pattern
- Poor R-wave progression (
- Atrial fibrillation
- First degree AV block
- Nonspecific ST-T-wave abnormalities
- Left bundle branch block can be potentially useful to differentiate ATTRwt-CA and AL-CA.
- Voltage-to-mass ratio, calculated by sum of S wave in lead V1 plus R wave in lead V5 or V6 (SV1 + RV5 or V6) divided by the echocardiographic muscle cross-sectional area has been shown to have high sensitivity and specificity for ATTRwt-CA.