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Senile cardiac amyloid Causes and Risks:
Amyloidosis involves deposits of a waxy, starch like protein ( amyloid ) in tissues. Extensive amyloid deposits decrease the function of the tissue. The cause is often unknown.
Cardiac amyloid presents as a restrictive cardiomyopathy or a dilated cardiomyopathy . There may be associated conduction disturbances (changes in the way the contraction impulse is transmitted through the heart). The deposits of amyloid protein are localized to the heart tissues.
Senile cardiac amyloid is differentiated from other forms of amyloidosis by its localization to the heart. There are no symptoms of systemic amyloidosis, long-term kidney failure , or effects on other organs or tissues.
Senile cardiac amyloid is a rare disorder, affecting adults, usually over 50 years old.
Prevention:
There is no known prevention.
Symptoms:
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: 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.
Treatment:
The treatment is aimed at control of symptoms.
Diuretics may be given to remove excess fluid. Digoxin and other medications are used cautiously to improve heart function. Analgesics may be used if there is pain.
The diet restrictions vary with the extent of cardiomyopathy and heart failure . They may include salt and/or fluid restrictions.
Physical activity may continue as tolerated.
A pacemaker may be indicated if there is symptomatic involvement of the conduction system. A heart transplant may be considered if heart function is very poor.
Daily weights may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may indicate excessive fluid accumulation.
Stop smoking and stop drinking alcohol. These habits will make the symptoms worse.
Prognosis:
The condition is chronic and progressive.
Complications:
Call Your Healthcare Provider:
Call your health care provider if you have this disorder and new symptoms develop, particularly:
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