Amyloid Cardiomyopathy

Perfusfind S.L.
Echocardiography Jan 1, 1970 0
Amyloid cardiomyopathy is a restrictive infiltrative disease that results in severe LV diastolic dysfunction and moderate LV systolic dysfunction. Classically, one may see a significant biatrial enlargement along with leaky valves and a pericardial effusion. Many of these features are shown in the off axis parasternal shot 1.

The ventricles can both become quite thick, but the EKG will still show low volts. This individual had biopsy proven cardiac amyloid, as it is a pathological diagnosis and solely with an echo it’s impossible to tell the etiology of the restrictive pattern. 

The color Doppler in 2 shows there is both aortic and mitral valve regurgitation.  

Note how thick both ventricles are in 3 parasternal short axis at the level of the mid ventricle. There is a small pericardial effusion appreciated here as well. A similar echo may be seen in someone with end stage renal disease on dialysis.

Video 4 : apical-4 chamber shows how massively dilated both atria are.  

They are similar in size to the ventricles. The RV is also enlarged and thickened. Both mitral and tricuspid annuli are enlarged. Look closely and you will see that in fact the tricuspid valve fails to properly coapt. Finally, on #5 you have a restrictive (highest grade of diastolic dysfunction) mitral filling pattern with a fast deceleration time and a small A wave.

From echocardiographer.org

Alex : is a last year medical student, very passionate about echo, POCUS and hand-held ultrasound devices.
He posts YouTube reviews of these, as well as interesting cases in Instagram (@mastersofultrasound) and Twitter (@mastersofultrasound).
 

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