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Wild-type (senile) amyloidosis electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

EKG findings encountered during the evaluation of a patient with wild-type (senile) amyloidosis include pseudoinfarct pattern, poor R wave progression, atrial fibrillation, first degree AV block, and nonspecific ST-T wave abnormalities. Voltage-to-mass ratio, calculated by the sum of S wave in lead V1 plus R wave in lead V5 or V6 (SV1 + RV5 or V6) divided by the echocardiographic muscle cross-sectional area, has been implicated to have high sensitivity and specificity for wild-type (senile) amyloidosis.

Electrocardiogram

  • The EKG findings in wild-type (senile) amyloidosis have low sensitivity and specificity for the condition.[1]
  • This is because the EKG findings are also common in aging patients suffering from comorbidities.
  • EKG findings encountered during the evaluation of a patient with wild-type (senile) amyloidosis are given below:

References

  1. Ilia G. Halatchev, Jingsheng Zheng & Jiafu Ou (2018). “Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA), previously known as senile cardiac amyloidosis: clinical presentation, diagnosis, management and emerging therapies”. Journal of thoracic disease. 10 (3): 2034–2045. doi:10.21037/jtd.2018.03.134. PMID 29707360. Unknown parameter |month= ignored (help)
  2. Thibaud Damy, Mathew S. Maurer, Claudio Rapezzi, Violaine Plante-Bordeneuve, Onur N. Karayal, Rajiv Mundayat, Ole B. Suhr & Arnt V. Kristen (2016). “Clinical, ECG and echocardiographic clues to the diagnosis of TTR-related cardiomyopathy”. Open heart. 3 (1): e000289. doi:10.1136/openhrt-2015-000289. PMID 26870387.
  3. Esther Gonzalez-Lopez, Christian Gagliardi, Fernando Dominguez, Cristina Candida Quarta, F. Javier de Haro-Del Moral, Agnese Milandri, Clara Salas, Mario Cinelli, Marta Cobo-Marcos, Massimiliano Lorenzini, Enrique Lara-Pezzi, Serena Foffi, Luis Alonso-Pulpon, Claudio Rapezzi & Pablo Garcia-Pavia (2017). “Clinical characteristics of wild-type transthyretin cardiac amyloidosis: disproving myths”. European heart journal. 38 (24): 1895–1904. doi:10.1093/eurheartj/ehx043. PMID 28329248. Unknown parameter |month= ignored (help)
  4. Esther Gonzalez-Lopez, Christian Gagliardi, Fernando Dominguez, Cristina Candida Quarta, F. Javier de Haro-Del Moral, Agnese Milandri, Clara Salas, Mario Cinelli, Marta Cobo-Marcos, Massimiliano Lorenzini, Enrique Lara-Pezzi, Serena Foffi, Luis Alonso-Pulpon, Claudio Rapezzi & Pablo Garcia-Pavia (2017). “Clinical characteristics of wild-type transthyretin cardiac amyloidosis: disproving myths”. European heart journal. 38 (24): 1895–1904. doi:10.1093/eurheartj/ehx043. PMID 28329248. Unknown parameter |month= ignored (help)
  5. Christoph Rocken, Brigitte Peters, Gina Juenemann, Wolfgang Saeger, Helmut U. Klein, Christof Huth, Albert Roessner & Andreas Goette (2002). “Atrial amyloidosis: an arrhythmogenic substrate for persistent atrial fibrillation”. Circulation. 106 (16): 2091–2097. doi:10.1161/01.cir.0000034511.06350.df. PMID 12379579. Unknown parameter |month= ignored (help)
  6. Nicole B. Cyrille, Jeff Goldsmith, Julissa Alvarez & Mathew S. Maurer (2014). “Prevalence and prognostic significance of low QRS voltage among the three main types of cardiac amyloidosis”. The American journal of cardiology. 114 (7): 1089–1093. doi:10.1016/j.amjcard.2014.07.026. PMID 25212550. Unknown parameter |month= ignored (help)
  7. Blaithnead Murtagh, Stephen C. Hammill, Morie A. Gertz, Robert A. Kyle, A. Jamil Tajik & Martha Grogan (2005). “Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement”. The American journal of cardiology. 95 (4): 535–537. doi:10.1016/j.amjcard.2004.10.028. PMID 15695149. Unknown parameter |month= ignored (help)
  8. Blaithnead Murtagh, Stephen C. Hammill, Morie A. Gertz, Robert A. Kyle, A. Jamil Tajik & Martha Grogan (2005). “Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement”. The American journal of cardiology. 95 (4): 535–537. doi:10.1016/j.amjcard.2004.10.028. PMID 15695149. Unknown parameter |month= ignored (help)
  9. Claudio Rapezzi, Giampaolo Merlini, Candida C. Quarta, Letizia Riva, Simone Longhi, Ornella Leone, Fabrizio Salvi, Paolo Ciliberti, Francesca Pastorelli, Elena Biagini, Fabio Coccolo, Robin M. T. Cooke, Letizia Bacchi-Reggiani, Diego Sangiorgi, Alessandra Ferlini, Michele Cavo, Elena Zamagni, Maria Luisa Fonte, Giovanni Palladini, Francesco Salinaro, Francesco Musca, Laura Obici, Angelo Branzi & Stefano Perlini (2009). “Systemic cardiac amyloidoses: disease profiles and clinical courses of the 3 main types”. Circulation. 120 (13): 1203–1212. doi:10.1161/CIRCULATIONAHA.108.843334. PMID 19752327. Unknown parameter |month= ignored (help)
  10. J. D. Carroll, W. H. Gaasch & K. P. McAdam (1982). “Amyloid cardiomyopathy: characterization by a distinctive voltage/mass relation”. The American journal of cardiology. 49 (1): 9–13. doi:10.1016/0002-9149(82)90270-3. PMID 6459025. Unknown parameter |month= ignored (help)

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