Cardiac Amyloidosis

DIAGNOSING AL AMYLOIDOSIS:
     Kidney or Liver Biopsy: ~90% sensitive
     Abdominal Fat Pad Aspirate: ~60-80% sensitive
     Rectal Biopsy: ~50-70% sensitive
     Bone Marrow Biopsy: ~50-55% sensitive
     Skin Biopsy: ~50% sensitive

For ease, convenience and yield, if AL amyloidosis is still suspected in the setting of a negative fat bad and bone marrow biopsy, then the affected organ should be biopsied (gold standard).

MOST COMMON EKG FINDINGS OF CARDIAC AMYLOID:
1. Low voltage (seen in 46% of cases)
2. Pseudoinfarction pattern: pathological Q waves, typically in leads II, III, aVF, and V1-V4 without echocardiographic e/o prior MI (seen in 47% of cases)