| Objective To explore the early diagnosis of cardiac amyloidosis by analyzing its clinical features.Material and methods Eight patients with cardiac involvement associated with primary amyloidosis were studied in this study. The data of clinical characteristics, electrocardiogram (ECG) and echocardiography (UCG) were analyzed. Biopsy specimens of subendocardiac muscle and lingual muscle were observed under light microscope. Prognosis was evaluated by follow-up for several months.Results The first symptoms of the patients were quite different but most presented as dyspnea. Heart failure was observed in 7 patients (4 cases with right heart failure and 3 cases with whole heart failure). What's more, 5 cases had hypotension but hypertension previously, and 5 had macroglossia. ECG showed that 6 patients were low voltage in the limb leads, combining with poor R wave progression in the precordial leads and ST-T changes in 5 patients; 6 patients had pseudoinfarction. UCG manifested that all of the patients were possessed of normal left ventricle, enlarged left atrium, increased thickness of the interventricular septums and left ventricular walls as well as diffuse weakness of the wall motion. Biopsy of subendocardiac muscle in 2 patients and lingual muscle in another six were collected and stained with HE. Typical deposition of amyloid were found in each one of them. Followed up for(23.6±11.3) months, all of the patients were died.Conclusion Amyloidosis is a systemic disease, whose cardiac involvement will manifest:①progressing refractory heart failure with normal ventricular chamber,②low–voltage QRS complexes with left ventricular hypertrophy,③progressing hypotension but hypertension previously or pseudoinfarction patterns,④thickened left ventricular wall with diffusely weakened wall motion,⑤tongue widen and thicken. However, biopsy of subendocardiac muscle or extracardiac tissue such as lingual muscle remains the definitive diagnostic method for cardiac amyloidosis.
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