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Sections Cardiac Amyloidosis
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Guidelines
- Medication
- Questions & Answers
- Media Gallery
- References
Diagnostic Considerations
Owing to the complexity of, and multisystem involvement in, cardiac amyloidosis, clinicians need to have a high index of suspicion for this condition and its varied presentation, [30] particularly in patients who present with heart failure and preserved ejection fraction. [38] Early recognition and treatment is essential in stopping the disease process before irreversible damage has occurred and improving survival. [38] Diagnostic evaluation includes findings on physical examination in conjunction with results of cardiac biomarker studies, noninvasive tests, and myocardial biopsy (as needed). Identification of the type of amyloidosis requires genetic studies. [30]
Clinicians should also consider infiltrative cardiomyopathy (ie, glycogen storage disease, Fabry disease, Hurler disease, and others) when evaluating patients with suspected cardiac amyloidosis.
Differential Diagnoses
Merlini G, Westermark P. The systemic amyloidoses: clearer understanding of the molecular mechanisms offers hope for more effective therapies. J Intern Med. 2004 Feb. 255(2):159-78. [QxMD MEDLINE Link].
Cohen AS. Amyloidosis. N Engl J Med. 1967 Sep 7. 277(10):522-30 contd. [QxMD MEDLINE Link].
Selvanayagam JB, Hawkins PN, Paul B, Myerson SG, Neubauer S. Evaluation and management of the cardiac amyloidosis. J Am Coll Cardiol. 2007 Nov 27. 50(22):2101-10. [QxMD MEDLINE Link].
Desai HV, Aronow WS, Peterson SJ, Frishman WH. Cardiac amyloidosis: approaches to diagnosis and management. Cardiol Rev. 2010 Jan-Feb. 18(1):1-11. [QxMD MEDLINE Link].
Sher T, Gertz MA. Recent advances in the diagnosis and management of cardiac amyloidosis. Future Cardiol. 2014 Jan. 10(1):131-46. [QxMD MEDLINE Link].
Merlini G, Bellotti V. Molecular mechanisms of amyloidosis. N Engl J Med. 2003 Aug 7. 349(6):583-96. [QxMD MEDLINE Link].
Falk RH, Comenzo RL, Skinner M. The systemic amyloidoses. N Engl J Med. 1997 Sep 25. 337(13):898-909. [QxMD MEDLINE Link].
Perfetti V, Colli Vignarelli M, Anesi E, et al. The degrees of plasma cell clonality and marrow infiltration adversely influence the prognosis of AL amyloidosis patients. Haematologica. 1999 Mar. 84(3):218-21. [QxMD MEDLINE Link].
Roberts WC, Waller BF. Cardiac amyloidosis causing cardiac dysfunction: analysis of 54 necropsy patients. Am J Cardiol. 1983 Jul. 52(1):137-46. [QxMD MEDLINE Link].
Smith TJ, Kyle RA, Lie JT. Clinical significance of histopathologic patterns of cardiac amyloidosis. Mayo Clin Proc. 1984 Aug. 59(8):547-55. [QxMD MEDLINE Link].
Arbustini E, Merlini G, Gavazzi A, et al. Cardiac immunocyte-derived (AL) amyloidosis: an endomyocardial biopsy study in 11 patients. Am Heart J. 1995 Sep. 130(3 pt 1):528-36. [QxMD MEDLINE Link].
Smith RR, Hutchins GM. Ischemic heart disease secondary to amyloidosis of intramyocardial arteries. Am J Cardiol. 1979 Sep. 44(3):413-7. [QxMD MEDLINE Link].
Mueller PS, Edwards WD, Gertz MA. Symptomatic ischemic heart disease resulting from obstructive intramural coronary amyloidosis. Am J Med. 2000 Aug 15. 109(3):181-8. [QxMD MEDLINE Link].
Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation. 2005 Sep 27. 112(13):2047-60. [QxMD MEDLINE Link].
Feng D, Edwards WD, Oh JK, et al. Intracardiac thrombosis and embolism in patients with cardiac amyloidosis. Circulation. 2007 Nov 20. 116(21):2420-6. [QxMD MEDLINE Link].
Mohty D, Pradel S, Magne J, et al. Prevalence and prognostic impact of left-sided valve thickening in systemic light-chain amyloidosis. Clin Res Cardiol. 2017 May. 106(5):331-40. [QxMD MEDLINE Link].
Ridolfi RL, Bulkley BH, Hutchins GM. The conduction system in cardiac amyloidosis. Clinical and pathologic features of 23 patients. Am J Med. 1977 May. 62(5):677-86. [QxMD MEDLINE Link].
Kyle RA, Linos A, Beard CM, et al. Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989. Blood. 1992 Apr 1. 79(7):1817-22. [QxMD MEDLINE Link].
Gertz MA, Lacy MQ, Dispenzieri A. Amyloidosis. Hematol Oncol Clin North Am. 1999 Dec. 13(6):1211-33, ix. [QxMD MEDLINE Link].
Dubrey SW, Cha K, Anderson J, et al. The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement. QJM. 1998 Feb. 91(2):141-57. [QxMD MEDLINE Link].
Usuku H, Obayashi K, Shono M, et al. Usefulness of plasma B-type natriuretic peptide as a prognostic marker of cardiac function in senile systemic amyloidosis and in familial amyloidotic polyneuropathy. Amyloid. 2013 Dec. 20(4):251-5. [QxMD MEDLINE Link].
Jacobson DR, Pastore RD, Yaghoubian R, et al. Variant-sequence transthyretin (isoleucine 122) in late-onset cardiac amyloidosis in black Americans. N Engl J Med. 1997 Feb 13. 336(7):466-73. [QxMD MEDLINE Link].
Martinez-Naharro A, Hawkins PN, Fontana M. Cardiac amyloidosis. Clin Med (Lond). 2018 Apr 1. 18(Suppl 2):s30-s35. [QxMD MEDLINE Link]. [Full Text].
Arruda-Olson AM, Zeldenrust SR, Dispenzieri A, et al. Genotype, echocardiography, and survival in familial transthyretin amyloidosis. Amyloid. 2013 Dec. 20(4):263-8. [QxMD MEDLINE Link].
Buck FS, Koss MN, Sherrod AE, Wu A, Takahashi M. Ethnic distribution of amyloidosis: an autopsy study. Mod Pathol. 1989 Jul. 2(4):372-7. [QxMD MEDLINE Link].
Takashio S, Izumiya Y, Jinnin M, et al. Diagnostic and prognostic value of subcutaneous tissue biopsy in patients with cardiac amyloidosis. Am J Cardiol. 2012 Nov 15. 110(10):1507-11. [QxMD MEDLINE Link].
Palladini G, Dispenzieri A, Gertz MA, et al. New criteria for response to treatment in immunoglobulin light chain amyloidosis based on free light chain measurement and cardiac biomarkers: impact on survival outcomes. J Clin Oncol. 2012 Dec 20. 30(36):4541-9. [QxMD MEDLINE Link].
Pennell DJ, Maceira AM. Magnetic resonance imaging in cardiac amyloidosis. JACC Cardiovasc Imaging. 2009 Dec. 2(12):1378-80. [QxMD MEDLINE Link].
Bodez D, Ternacle J, Guellich A, et al. Prognostic value of right ventricular systolic function in cardiac amyloidosis. Amyloid. 2016 Sep. 23(3):158-67. [QxMD MEDLINE Link].
Ritts AJ, Cornell RF, Swiger K, Singh J, Goodman S, Lenihan DJ. Current concepts of cardiac amyloidosis: diagnosis, clinical management, and the need for collaboration. Heart Fail Clin. 2017 Apr. 13(2):409-16. [QxMD MEDLINE Link].
Chamarthi B, Dubrey SW, Cha K, Skinner M, Falk RH. Features and prognosis of exertional syncope in light-chain associated AL cardiac amyloidosis. Am J Cardiol. 1997 Nov 1. 80(9):1242-5. [QxMD MEDLINE Link].
Al Suwaidi J, Velianou JL, Gertz MA, et al. Systemic amyloidosis presenting with angina pectoris. Ann Intern Med. 1999 Dec 7. 131(11):838-41. [QxMD MEDLINE Link].
Navarro JF, Rivera M, Ortuno J. Cardiac tamponade as presentation of systemic amyloidosis. Int J Cardiol. 1992 Jul. 36(1):107-8. [QxMD MEDLINE Link].
Mathew V, Olson LJ, Gertz MA, Hayes DL. Symptomatic conduction system disease in cardiac amyloidosis. Am J Cardiol. 1997 Dec 1. 80(11):1491-2. [QxMD MEDLINE Link].
Zubkov AY, Rabinstein AA, Dispenzieri A, Wijdicks EF. Primary systemic amyloidosis with ischemic stroke as a presenting complication. Neurology. 2007 Sep 11. 69(11):1136-41. [QxMD MEDLINE Link].
Daoud MS, Lust JA, Kyle RA, Pittelkow MR. Monoclonal gammopathies and associated skin disorders. J Am Acad Dermatol. 1999 Apr. 40(4):507-35; quiz 536-8. [QxMD MEDLINE Link].
Burroughs EI, Aronson AE, Duffy JR, Kyle RA. Speech disorders in systemic amyloidosis. Br J Disord Commun. 1991 Aug. 26(2):201-6. [QxMD MEDLINE Link].
Bhogal S, Ladia V, Sitwala P, et al. Cardiac amyloidosis: an updated review with emphasis on diagnosis and future directions. Curr Probl Cardiol. 2018 Jan. 43(1):10-34. [QxMD MEDLINE Link].
Damy T, Deux JF, Moutereau S, et al. Role of natriuretic peptide to predict cardiac abnormalities in patients with hereditary transthyretin amyloidosis. Amyloid. 2013 Dec. 20(4):212-20. [QxMD MEDLINE Link].
Aljama MA, Sidiqi MH, Dispenzieri A, et al. Comparison of different techniques to identify cardiac involvement in immunoglobulin light chain (AL) amyloidosis. Blood Adv. 2019 Apr 23. 3(8):1226-9. [QxMD MEDLINE Link]. [Full Text].
Hamer JP, Janssen S, van Rijswijk MH, Lie KI. Amyloid cardiomyopathy in systemic non-hereditary amyloidosis. Clinical, echocardiographic and electrocardiographic findings in 30 patients with AA and 24 patients with AL amyloidosis. Eur Heart J. 1992 May. 13(5):623-7. [QxMD MEDLINE Link].
Nishikawa H, Nishiyama S, Nishimura S, et al. Echocardiographic findings in nine patients with cardiac amyloidosis: their correlation with necropsy findings. J Cardiol. 1988 Mar. 18(1):121-33. [QxMD MEDLINE Link].
Siqueira-Filho AG, Cunha CL, Tajik AJ, Seward JB, Schattenberg TT, Giuliani ER. M-mode and two-dimensional echocardiographic features in cardiac amyloidosis. Circulation. 1981 Jan. 63(1):188-96. [QxMD MEDLINE Link].
Pradel S, Magne J, Jaccard A, et al. Left ventricular assessment in patients with systemic light chain amyloidosis: a 3-dimensional speckle tracking transthoracic echocardiographic study. Int J Cardiovasc Imaging. 2019 May. 35(5):845-54. [QxMD MEDLINE Link].
Rahman JE, Helou EF, Gelzer-Bell R, et al. Noninvasive diagnosis of biopsy-proven cardiac amyloidosis. J Am Coll Cardiol. 2004 Feb 4. 43(3):410-5. [QxMD MEDLINE Link].
Bellavia D, Abraham TP, Pellikka PA, et al. Detection of left ventricular systolic dysfunction in cardiac amyloidosis with strain rate echocardiography. J Am Soc Echocardiogr. 2007 Oct. 20(10):1194-202. [QxMD MEDLINE Link].
Klein AL, Hatle LK, Taliercio CP, et al. Serial Doppler echocardiographic follow-up of left ventricular diastolic function in cardiac amyloidosis. J Am Coll Cardiol. 1990 Nov. 16(5):1135-41. [QxMD MEDLINE Link].
Hongo M, Kono J, Yamada H, et al. Doppler echocardiographic assessments of left ventricular diastolic filling in patients with amyloid heart disease. J Cardiol. 1991. 21(2):391-401. [QxMD MEDLINE Link].
Ha JW, Ommen SR, Tajik AJ, et al. Differentiation of constrictive pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue Doppler echocardiography. Am J Cardiol. 2004 Aug 1. 94(3):316-9. [QxMD MEDLINE Link].
Schiano-Lomoriello V, Galderisi M, Mele D, et al. Longitudinal strain of left ventricular basal segments and E/e' ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study. Echocardiography. 2016 Sep. 33(9):1335-43. [QxMD MEDLINE Link].
Salinaro F, Meier-Ewert HK, Miller EJ, et al. Longitudinal systolic strain, cardiac function improvement, and survival following treatment of light-chain (AL) cardiac amyloidosis. Eur Heart J Cardiovasc Imaging. 2017 Sep 1. 18(9):1057-64. [QxMD MEDLINE Link].
Bodez D, Ternacle J, Guellich A, et al. Prognostic value of right ventricular systolic function in cardiac amyloidosis. Amyloid. 2016 Sep. 23(3):158-67. [QxMD MEDLINE Link].
Mohty D, Pibarot P, Dumesnil JG, et al. Left atrial size is an independent predictor of overall survival in patients with primary systemic amyloidosis. Arch Cardiovasc Dis. 2011 Dec. 104(12):611-8. [QxMD MEDLINE Link].
Kwong RY, Heydari B, Abbasi S, et al. Characterization of cardiac amyloidosis by atrial late gadolinium enhancement using contrast-enhanced cardiac magnetic resonance imaging and correlation with left atrial conduit and contractile function. Am J Cardiol. 2015 Aug 15. 116(4):622-9. [QxMD MEDLINE Link].
Maceira AM, Joshi J, Prasad SK, et al. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2005 Jan 18. 111(2):186-93. [QxMD MEDLINE Link].
Ruberg FL, Appelbaum E, Davidoff R, et al. Diagnostic and prognostic utility of cardiovascular magnetic resonance imaging in light-chain cardiac amyloidosis. Am J Cardiol. 2009 Feb 15. 103(4):544-9. [QxMD MEDLINE Link]. [Full Text].
Austin BA, Tang WH, Rodriguez ER, et al. Delayed hyper-enhancement magnetic resonance imaging provides incremental diagnostic and prognostic utility in suspected cardiac amyloidosis. JACC Cardiovasc Imaging. 2009 Dec. 2(12):1369-77. [QxMD MEDLINE Link].
Maceira AM, Prasad SK, Hawkins PN, Roughton M, Pennell DJ. Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis. J Cardiovasc Magn Reson. 2008 Nov 25. 10:54. [QxMD MEDLINE Link]. [Full Text].
Barison A, Aquaro GD, Pugliese NR, et al. Measurement of myocardial amyloid deposition in systemic amyloidosis: insights from cardiovascular magnetic resonance imaging. J Intern Med. 2015 May. 277(5):605-14. [QxMD MEDLINE Link].
Kuetting DL, Homsi R, Sprinkart AM, et al. Quantitative assessment of systolic and diastolic function in patients with LGE negative systemic amyloidosis using CMR. Int J Cardiol. 2017 Apr 1. 232:336-41. [QxMD MEDLINE Link].
Falk RH, Lee VW, Rubinow A, Hood WB Jr, Cohen AS. Sensitivity of technetium-99m-pyrophosphate scintigraphy in diagnosing cardiac amyloidosis. Am J Cardiol. 1983 Mar 1. 51(5):826-30. [QxMD MEDLINE Link].
Cytawa W, Teodorczyk J, Lass P. Nuclear imaging of amyloidosis. Pol J Radiol. 2014 Jul 24. 79:222-7. [QxMD MEDLINE Link]. [Full Text].
Bokhari S, Castano A, Pozniakoff T, Deslisle S, Latif F, Maurer MS. (99m)Tc-pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses. Circ Cardiovasc Imaging. 2013 Mar 1. 6(2):195-201. [QxMD MEDLINE Link]. [Full Text].
Hawkins PN. Serum amyloid P component scintigraphy for diagnosis and monitoring amyloidosis. Curr Opin Nephrol Hypertens. 2002 Nov. 11(6):649-55. [QxMD MEDLINE Link].
Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M. Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement. Am J Cardiol. 2005 Feb 15. 95(4):535-7. [QxMD MEDLINE Link].
Dubrey SW, Bilazarian S, LaValley M, Reisinger J, Skinner M, Falk RH. Signal-averaged electrocardiography in patients with AL (primary) amyloidosis. Am Heart J. 1997 Dec. 134(6):994-1001. [QxMD MEDLINE Link].
Reyners AK, Hazenberg BP, Reitsma WD, Smit AJ. Heart rate variability as a predictor of mortality in patients with AA and AL amyloidosis. Eur Heart J. 2002 Jan. 23(2):157-61. [QxMD MEDLINE Link].
Reisinger J, Dubrey SW, Lavalley M, Skinner M, Falk RH. Electrophysiologic abnormalities in AL (primary) amyloidosis with cardiac involvement. J Am Coll Cardiol. 1997 Oct. 30(4):1046-51. [QxMD MEDLINE Link].
Pellikka PA, Holmes DR Jr, Edwards WD, Nishimura RA, Tajik AJ, Kyle RA. Endomyocardial biopsy in 30 patients with primary amyloidosis and suspected cardiac involvement. Arch Intern Med. 1988 Mar. 148(3):662-6. [QxMD MEDLINE Link].
Ardehali H, Qasim A, Cappola T, et al. Endomyocardial biopsy plays a role in diagnosing patients with unexplained cardiomyopathy. Am Heart J. 2004 May. 147(5):919-23. [QxMD MEDLINE Link].
Pomerance A, Slavin G, McWatt J. Experience with the sodium sulphate-Alcian Blue stain for amyloid in cardiac pathology. J Clin Pathol. 1976 Jan. 29(1):22-6. [QxMD MEDLINE Link]. [Full Text].
Kyle RA, Spencer RJ, Dahlin DC. Value of rectal biopsy in the diagnosis of primary systemic amyloidosis. Am J Med Sci. 1966 May. 251(5):501-6. [QxMD MEDLINE Link].
Ansari-Lari MA, Ali SZ. Fine-needle aspiration of abdominal fat pad for amyloid detection: a clinically useful test?. Diagn Cytopathol. 2004 Mar. 30(3):178-81. [QxMD MEDLINE Link].
US Food and Drug Administration. FDA approves new treatments for heart disease caused by a serious rare disease, transthyretin mediated amyloidosis. Available at https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatments-heart-disease-caused-serious-rare-disease-transthyretin-mediated. May 7, 2019; Accessed: May 8, 2019.
Maurer MS, Schwartz JH, Gundapaneni B, et al, for the ATTR-ACT Study Investigators. Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. N Engl J Med. 2018 Sep 13. 379(11):1007-16. [QxMD MEDLINE Link]. [Full Text].
[Guideline] O'Meara E, McDonald M, Chan M, et al. CCS/CHFS heart failure guidelines: clinical trial update on functional mitral regurgitation, SGLT2 Inhibitors, ARNI in HFpEF, and tafamidis in amyloidosis. Can J Cardiol. 2020 Feb. 36(2):159-69. [QxMD MEDLINE Link]. [Full Text].
Palladini G, Sachchithanantham S, Milani P, et al. A European collaborative study of cyclophosphamide, bortezomib, and dexamethasone in upfront treatment of systemic AL amyloidosis. Blood. 2015 Jul 30. 126(5):612-5. [QxMD MEDLINE Link].
Sperry BW, Ikram A, Hachamovitch R, et al. Efficacy of chemotherapy for light-chain amyloidosis in patients presenting with symptomatic heart failure. J Am Coll Cardiol. 2016 Jun 28. 67(25):2941-8. [QxMD MEDLINE Link].
Sanchorawala V, Wright DG, Seldin DC, et al. Low-dose continuous oral melphalan for the treatment of primary systemic (AL) amyloidosis. Br J Haematol. 2002 Jun. 117(4):886-9. [QxMD MEDLINE Link].
Seldin DC, Anderson JJ, Sanchorawala V, et al. Improvement in quality of life of patients with AL amyloidosis treated with high-dose melphalan and autologous stem cell transplantation. Blood. 2004 Sep 15. 104(6):1888-93. [QxMD MEDLINE Link].
Sanchorawala V, Wright DG, Seldin DC, et al. An overview of the use of high-dose melphalan with autologous stem cell transplantation for the treatment of AL amyloidosis. Bone Marrow Transplant. 2001 Oct. 28(7):637-42. [QxMD MEDLINE Link].
Palladini G, Perfetti V, Obici L, et al. Association of melphalan and high-dose dexamethasone is effective and well tolerated in patients with AL (primary) amyloidosis who are ineligible for stem cell transplantation. Blood. 2004 Apr 15. 103(8):2936-8. [QxMD MEDLINE Link].
Palladini G, Perfetti V, Perlini S, et al. The combination of thalidomide and intermediate-dose dexamethasone is an effective but toxic treatment for patients with primary amyloidosis (AL). Blood. 2005 Apr 1. 105(7):2949-51. [QxMD MEDLINE Link].
Wechalekar AD, Goodman HJ, Lachmann HJ, Offer M, Hawkins PN, Gillmore JD. Safety and efficacy of risk-adapted cyclophosphamide, thalidomide, and dexamethasone in systemic AL amyloidosis. Blood. 2007 Jan 15. 109(2):457-64. [QxMD MEDLINE Link].
Wechalekar AD, Hawkins PN, Gillmore JD. Perspectives in treatment of AL amyloidosis. Br J Haematol. 2008 Feb. 140(4):365-77. [QxMD MEDLINE Link].
Grogan M, Gertz M, McCurdy A, et al. Long term outcomes of cardiac transplant for immunoglobulin light chain amyloidosis: The Mayo Clinic experience. World J Transplant. 2016 Jun 24. 6(2):380-8. [QxMD MEDLINE Link].
Rubinow A, Skinner M, Cohen AS. Digoxin sensitivity in amyloid cardiomyopathy. Circulation. 1981 Jun. 63(6):1285-8. [QxMD MEDLINE Link].
Feng D, Syed IS, Martinez M, et al. Intracardiac thrombosis and anticoagulation therapy in cardiac amyloidosis. Circulation. 2009 May 12. 119(18):2490-7. [QxMD MEDLINE Link].
Dubrey SW. Amyloid heart disease: a brief review of treatment options. Postgrad Med J. 2012 Dec. 88(1046):700-5. [QxMD MEDLINE Link].
Migrino RQ, Truran S, Gutterman DD, et al. Human microvascular dysfunction and apoptotic injury induced by AL amyloidosis light chain proteins. Am J Physiol Heart Circ Physiol. 2011 Dec. 301(6):H2305-12. [QxMD MEDLINE Link].
Palladini G, Barassi A, Perlini S, et al. Midregional proadrenomedullin (MR-proADM) is a powerful predictor of early death in AL amyloidosis. Amyloid. 2011 Dec. 18(4):216-21. [QxMD MEDLINE Link].
Ikeda S, Sekijima Y, Tojo K, Koyama J. Diagnostic value of abdominal wall fat pad biopsy in senile systemic amyloidosis. Amyloid. 2011 Dec. 18(4):211-5. [QxMD MEDLINE Link].
Kumar S, Dispenzieri A, Katzmann JA, et al. Serum immunoglobulin free light-chain measurement in primary amyloidosis: prognostic value and correlations with clinical features. Blood. 2010 Dec 9. 116(24):5126-9. [QxMD MEDLINE Link].
Tapan U, Seldin DC, Finn KT, et al. Increases in B-type natriuretic peptide (BNP) during treatment with lenalidomide in AL amyloidosis. Blood. 2010 Dec 2. 116(23):5071-2. [QxMD MEDLINE Link].
McCausland KL, Quock TP, Rizio AA, et al. Cardiac biomarkers and health-related quality of life in patients with light chain (AL) amyloidosis. Br J Haematol. 2019 Jun. 185(5):998-1001. [QxMD MEDLINE Link].
Manwani R, Hegenbart U, Mahmood S, et al. Deferred autologous stem cell transplantation in systemic AL amyloidosis. Blood Cancer J. 2018 Nov 5. 8(11):101. [QxMD MEDLINE Link]. [Full Text].
Kim HM, Sohn DW, Paeng JC. Prevalence of positive 99mTc-DPD scintigraphy as an indicator of the prevalence of wild-type transthyretin amyloidosis in the elderly. Int Heart J. 2019 May 30. 60(3):643-7. [QxMD MEDLINE Link].
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Low voltage complexes, atrial fibrillation.
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Long axis parasternal view: Left ventricular hypertrophy (LVH) with sparkling appearance, pericardial effusion.
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Short axis view: Left ventricular hypertrophy (LVH), pericardial effusion, normal RV size.
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Short axis left ventricle: Global subendocardial gadolinium enhancement.
Tables
Gyanendra K Sharma, MD, FACC, FASE Professor of Medicine and Radiology, Director, Adult Echocardiography Laboratory, Section of Cardiology, Medical College of Georgia at Augusta University
Gyanendra K Sharma, MD, FACC, FASE is a member of the following medical societies: American Association of Cardiologists of Indian Origin, American Association of Physicians of Indian Origin, American College of Cardiology, American Society of Echocardiography, Society for Cardiovascular Magnetic Resonance, Society of Cardiovascular Computed Tomography
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Received salary from Medscape for employment. for: Medscape.
Terrence X O'Brien, MD, MS, FACC Professor of Medicine/Cardiology, Director, Clinical Cardiovascular Research, Medical University of South Carolina College of Medicine; Director, Echocardiography Laboratory, Veterans Affairs Medical Center of Charleston
Terrence X O'Brien, MD, MS, FACC is a member of the following medical societies: American College of Cardiology, American Heart Association, American Society of Echocardiography, Heart Failure Society of America, South Carolina Medical Association
Disclosure: Nothing to disclose.
Acknowledgments
I like to sincerely thank Chinmaya Sharma for his editorial assistance in the manuscript preparation.
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Sections Cardiac Amyloidosis
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Guidelines
- Medication
- Questions & Answers
- Media Gallery
- References
