Cardiac amyloidosis simulating hypertrophic cardiomyopathy

Sedlis, Steven P.; Saffitz, Jeffrey E.; Schwob, Valerie S.; Jaffe, Allan S.

doi:10.1016/0002-9149(84)90543-5

Cited by 36 publications

(8 citation statements)

References 3 publications

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“…Systolic anterior movement of the mitral valve is commonly seen in hypertrophic cardiomyopathy, but it is not invariably present and has also been reported in several other cardiac conditions. To the best of our knowledge, however, this feature has only been described in a few cases of cardiac amyloidosis (6,8). It was not observed in any of the present amyloidosis patients, and its presence strongly suggested hypertrophic cardiomyopathy.…”

Section: Left Ventricular Mass (Lvm) Systolic Anterior Movement Ofcontrasting

confidence: 53%

Differentiation of Cardiac Amyloidosis and Hypertrophic Cardiomyopathy

Eriksson

Backman

Eriksson

et al. 1987

Journal of Internal Medicine

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ABSTRACT. Eriksson P, Backman C, Eriksson A, Eriksson S, Karp K, Olofsson B‐O (Departments of Internal Medicine, Geriatric Medicine, and Clinical Physiology, University Hospital, Umeå, and Institute of Forensic Medicine, University of Umeå, Umeå, Sweden). Differentiation of cardiac amyloidosis and hypertrophic cardiomyopathy. A comparison of familial amyloidosis with polyneuropathy and hypertrophic cardiomyopathy by electrocardiography and echocardiography. Acta Med Scand 1987; 221:39–46. The clinical and echocardiographic features of cardiac amyloidosis may closely resemble those of hypertrophic cardiomyopathy, and the disorders may thus be mixed up. The present study was undertaken in an attempt to identify features separating the two conditions by analysis of electro‐ and echocardiographic findings in patients with familial amyloid polyneuropathy and hypertrophic cardiomyopathy. Twenty‐nine patients with familial amyloidosis and 22 with hypertrophic cardiomyopathy were studied. Particular attention was given to (1) the sum of the S wave in V1 and R wave in V5 or V6, (2) the echocardiographic left ventricular mass and (3) cross‐sectional area, the presence or absence of (4) asymmetrical septal thickening, (5) granular and sparkling myocardial appearance, (6) thickened heart valves, (7) systolic anterior motion of the mitral valve, and (8) pericardial effusion. A granular and sparkling appearance of the myocardium and thickened heart valves were found to be the best predictors of cardiac amyloidosis, while low QRS amplitudes in relation to echocardiographic left ventricular mass and a pericardial effusion seemed less important. The presence of systolic anterior movement of the mitral valve, a large left ventricular mass and a sum of S in V1 and R in V5 or V6 >35 mm indicated hypertrophic cardiomyopathy. When the four strongest predictors (left ventricular mass, thickened heart valves, a granular sparkling myocardial appearance, and systolic anterior movement of the mitral valve) were used to reclassify the present patients, 28 of 29 amyloidosis patients and 21 of 22 patients with hypertrophic cardiomyopathy were correctly categorized. Noninvasive methods may thus be useful for detecting the myocardial infiltrative process, and cardiac amyloidosis may be confidently diagnosed by typical noninvasive findings together with histopathological documentation of amyloid in an organ other than the heart.

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Section: Left Ventricular Mass (Lvm) Systolic Anterior Movement Ofcontrasting

confidence: 53%

Differentiation of Cardiac Amyloidosis and Hypertrophic Cardiomyopathy

Eriksson

Backman

Eriksson

et al. 1987

Journal of Internal Medicine

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“…38 In Ϸ5% of patients with cardiac amyloidosis, left ventricular infiltration may mimic hypertrophic cardiomyopathy on the echocardiogram. 10,39,40 These patients often have normal or even mildly hyperdynamic left ventricular function with normal voltage on the ECG. Associated postural hypotension is common in these patients, and low afterload may in part account for the normal to increased ejection fraction.…”

Section: Clinical Featuresmentioning

confidence: 99%

Diagnosis and Management of the Cardiac Amyloidoses

2005

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“…Primary cardiac amyloidosis may also present as hypertrophic cardiomyopathy with left Acta Med Scand 1986; 219 Cardiac amyloidosis 127 ventricular obstruction (2, 8, 151, but a case with echocardiographic evidence of obstruction has also been reported (16). In our patient 2 the echocardiogram showed asymmetric septa1 hypertrophy.…”

Section: Discussionmentioning

confidence: 54%

Cardiac Amyloidosis

Leinonen

Pohjola-Sintonen

1986

Journal of Internal Medicine

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ABSTRACT. Two male patients with primary cardiac amyloidosis are described. Patient 1 presented with typical effort angina pectoris with no ischemic electrocardiographic changes and a normal coronary angiogram. At necropsy, a severe diffuse, intravascular amyloid deposition was observed in the intramural coronary arteries. In patient 2 the presenting symptom was congestive heart failure with echocardiographic evidence of asymmetric septal hypertrophy and pericardial effusion. Technetium‐99m pyrophosphate scintigraphy showed diffuse myocardial uptake, and the diagnosis of cardiac amyloidosis was confirmed in the postmortem examination. The diagnostic and therapeutic problems associated with cardiac amyloidosis are discussed in the light of these case reports.

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Cardiac amyloidosis simulating hypertrophic cardiomyopathy

Cited by 36 publications

References 3 publications

Differentiation of Cardiac Amyloidosis and Hypertrophic Cardiomyopathy

Differentiation of Cardiac Amyloidosis and Hypertrophic Cardiomyopathy

Diagnosis and Management of the Cardiac Amyloidoses

Cardiac Amyloidosis

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