Secondary amyloidosis electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Shyam Patel [3]

Overview

An ECG may be helpful in the diagnosis of secondary amyloidosis. Possible ECG findings associated with the diagnosis of cardiac involvement include low voltage QRS complexes, Left ventricular hypertrophy, Right ventricular hypertrophy, and atrioventricular block.

An ECG may be helpful in the diagnosis of secondary amyloidosis. Findings on an ECG suggestive of cardiac involvement include:^[1]
- Voltage is lower than 5 mm in all limb leads.
Other possible findings include:
- Left ventricular hypertrophy^[2]
- Right ventricular hypertrophy
- Left atrial abnormalities
Pathological Q waves^[2]
- Atrioventricular block: AV block occur due to deposition of amyloid fibrils in the conduction tissue.
Cardiac involvement rarely occurs in the secondary amyloidosis and other possible cause should be ruled out first.^[3]

↑ Real de Asua, Diego; Galvan, Jose Maria; Filigghedu, Maria Teresa; Trujillo, Davinia; Costa, Ramon; Cadinanos, Julen (2014). “Systemic AA amyloidosis: epidemiology, diagnosis, and management”. Clinical Epidemiology: 369. doi:10.2147/CLEP.S39981. ISSN 1179-1349.
↑ ^2.0 ^2.1 Damy T, Judge DP, Kristen AV, Berthet K, Li H, Aarts J (2015). “Cardiac findings and events observed in an open-label clinical trial of tafamidis in patients with non-Val30Met and non-Val122Ile hereditary transthyretin amyloidosis”. J Cardiovasc Transl Res. 8 (2): 117–27. doi:10.1007/s12265-015-9613-9. PMC 4382536. PMID 25743445.
↑ Papa, Riccardo; Lachmann, Helen J. (2018). “Secondary, AA, Amyloidosis”. Rheumatic Disease Clinics of North America. 44 (4): 585–603. doi:10.1016/j.rdc.2018.06.004. ISSN 0889-857X.