Cardiac amyloidosis

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Heart, section through the middle

Dilated cardiomyopathy

Cardiac amyloidosis

Alternative Names:

Amyloidosis - cardiac; Restrictive cardiomyopathy - amyloidosis; Primary cardiac amyloidosis - AL type; secondary cardiac amyloidosis - AA type; Stiff heart syndrome
Symptoms:

palpitations (sensation of feeling heart beat)
swelling of legs, ankles, or other portion of the body (such as abdominal swelling or enlargement)
excessive urination at night
fatigue, reduced activity tolerance
shortness of breath with activity
breathing difficulty while lying down

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Some patients may have no symptoms.

Signs and tests:

The diagnosis of cardiac amyloidosis is difficult to make. The findings from an examination are not specific and may indicate enlargement of the heart and fluid in the lungs.

Listening with a stethoscope may reveal lung crackles, heart murmurs, or other abnormal sounds. The liver may be enlarged and neck veins may be distended. The blood pressure may be low or may drop when rising to a standing position (orthostatic hypotension).

Heart enlargement, congestion of the lungs or the veins in the lungs, decreased movement and/or functioning of the heart, heart failure, or signs of amyloidosis in the heart and other organs may show on the following tests:

An ECG may reveal conduction disturbances, arrhythmias such as atrial fibrillation, ventricular tachycardia, or premature/ectopic beats.

An echocardiogram may be used to assess the thickness of the heart wall, the size of the chambers in the heart, and the ability of the heart to fill and pump blood. Sometimes an unusual texture of the heart muscle or the endocardium (the lining of the heart) can be seen as well.

A cardiac biopsy that reveals amyloid confirms the diagnosis. Biopsy of other tissues may also confirm the diagnosis. Amyloidosis is frequently confirmed by biopsy of abdominal fat, kidney, or bone marrow.