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. | 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== | ||
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 | * [[Pseudo-infarct pattern]] of [[poor R wave progression]] | ||
* Left ventricular hypertrophy | * [[Left ventricular hypertrophy on electrocardiogram|Left ventricular hypertrophy]] | ||
* Higher degree AV | * 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]] | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[CME Category::Cardiology]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
Latest revision as of 20:20, 5 February 2020
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Cardiac amyloidosis electrocardiogram On the Web |
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Risk calculators and risk factors for Cardiac amyloidosis electrocardiogram |
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]
- Low voltage complexes
- Pseudo-infarct pattern of poor R wave progression
- Left ventricular hypertrophy
- Higher degree AV blocks
- Bundle branch blocks: Left bundle branch block is seen in 40% of the patients with wild-type ATTR versus 4% of those with AL amyloid type.
- AV nodal slowing of heart rate
- Arrhythmias, such as
References
- ↑ 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) - ↑ 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) - ↑ 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)