| Two-dimensional echocardiography in myocardial amyloidosis. | |
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MedLine Citation:
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PMID: 10149255 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Two-dimensional echocardiography is the best means of identifying early cardiac amyloid infiltration and gauging its subsequent progression. The early asymptomatic phase is characterized on echocardiography by a mild-to-moderate increase in left ventricular and/or right ventricular wall thicknesses. The distinctive combination of low electrocardiography voltage and increase in left ventricular mass on the echocardiogram, both compatible with substantial amyloid infiltration, is valuable in diagnosis and appears to indicate the severity of the disease. Other ancillary but common findings are left atrial dilatation, a small pericardial effusion, thickening of cardiac valves, papillary muscles, and interatrial septum. Finally, there is a peculiar texture of myocardial walls, with highly refractile areas that are typical, although not specific, of myocardial amyloidosis and can also be quantitatively described by digital image analysis techniques. The echocardiographic appearance of amyloidosis can closely mimic several other diseases. Asymmetric hypertrophy of the septum due to amyloid deposition may occur, simulating hypertrophic cardiomyopathy. The granular sparkling of myocardial walls is also found in myocarditis with severe fibrosis, and it is quite common in hypertrophic cardiomyopathy, as well as in other infiltrative diseases of the myocardium. It is not uncommon that the echocardiographic examination represents a turning point in the work-up of the patient, briskly orienting the clinician towards the correct diagnostic pathway. However, the likelihood of the cardiologist-echocardiographer to successfully and prospectively identify myocardial amyloidosis is substantially higher if all the clinical and electrocardiographic information is reviewed at the time of the echocardiographic examination. |
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Authors:
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E Picano; B Pinamonti; E M Ferdeghini; L Landini; G Slavich; A Orlandini; C Marini; F Lattanzi; F Camerini |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Echocardiography (Mount Kisco, N.Y.) Volume: 8 ISSN: 0742-2822 ISO Abbreviation: Echocardiography Publication Date: 1991 Mar |
Date Detail:
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Created Date: 1992-08-27 Completed Date: 1992-08-27 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8511187 Medline TA: Echocardiography Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 253-9 Citation Subset: T |
Affiliation:
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C.N.R. Clinical Physiology Institute of Pisa, Trieste, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Amyloidosis
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ultrasonography* Cardiomyopathies / ultrasonography* Echocardiography / methods* Humans Ultrasonics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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