Cardiac Amyloidosis (RCM) Flashcards
True or false; in cardiac amyloidosis you get biventricular wall thickening?
True.
How is the myocardium described in Amyloid?
Granular or “sparkling”/Increased echogenecity.
True or false; in cardiac amyloidosis there is significantly reduced longitudinal function (in both ventricles).
True.
With regards to valves, what is a common finding in Amyloid?
Thickening with mild dysfunction.
With regards to the IVS, what is a common finding in Amyloid?
IAS thickening.
True or false; a small pericardial or pleural effusion may be present with Amyloid.
True.
What should be done when suspecting a granular or “sparkling”/increased echogenecity appearance to the myocardium or thickening of the valves?
Turn off harmonics.
What are the “normal” LV findings (with regards to systolic function) in Amyloid?
Usually non-dilated with normal function (or hyperdynamic Fx) but may become dilated later on in the disease.
Longitudinal function is impaired with Amyloid, what is considered reduced for a MAPSE measurement?
<10mm.
Why is LV function often hyperdynamic with Amyloid?
To compensate for reduced longitudinal function.
Mitral annular TDI velocities are ALL typically markedly reduced, being less than what?
<5cm/s (5-5-5 sign).
In cardiac Amyloidosis, what is a typical strain pattern?
Apical sparing - “bull’s eye” appearance.
In what other cohort of patients can the “apical sparing” strain pattern be seen in?
The elderly aortic stenosis cohort (in up to 20% of them).
Why does the ECG of Amyloid patients often show low voltage rather than the typical LVH criteria?
Because wall thickening is not due to myocyte hypertrophy but rather due to interstitial infiltration with myocyte loss.
Other than LVH/low voltage criteria, what else may been seen on the ECG of Amyloid patients?
Q Waves (pseudoinfarction pattern).
