Cardiac amyloidosis echocardiography

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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

Transthoracic echocardiography is most commonly used in the initial evaluation of cardiac amyloidosis. The most common echocardiographic finding is thickening of the left ventricle.

Echocardiography

Findings on echocardiography include:

• Thickening of the left ventricle
• Granular or sparkling appearance of the myocardium secondary to amyloid deposition in the myocardium. This finding is especially seen best with two dimentional echocardiography as hyperrefractile myocardial echoes.
• Thickening of interventricular septum
• Diastolic dysfunction
• Normal or reduced LV cavity
• Pericardial effusion
• RV hypertrophy
• Left atrial enlargement
• Thickened AV valves
• Right ventricular dilatation (poor prognostic marker indicating right heart failure)

The combination of increased thickness of the left ventricular posterior wall and interventricular septum with a low voltage electrocardiographic pattern is highly specific for cardiac amyloidosis. In an echocardiographic study conducted in 54 patients (30 with AA type cardiac amyloidosis and 24 with AL type amyloidosis) it was found that this finding is more often seen in the AL type cardiac amyloidosis.

References

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