Senile cardiac amyloid

Alternative names:

amyloidosis - cardiac; cardiac amyloid

Symptoms:

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

Note: The disease may be asymptomatic.

Signs and tests:

The diagnosis is difficult to make. The findings from an examination are nonspecific. Percussion and palpation may indicate enlargement of the heart and fluid in the lungs. Auscultation 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, or heart failure may show on:

• echocardiogram
• chest X-ray
• chest CT scan
• coronary angiography
• nuclear heart scans (MUGA, RNV)

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 can be seen by echocardiogram.

A heart muscle biopsy that reveals amyloid confirms the diagnosis.

Although no lab tests are specific for senile cardiac amyloid, many tests may be necessary.