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Cardiac amyloidosis


Definition:

Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly.

Alternative Names:

Amyloidosis - cardiac; Primary cardiac amyloidosis - AL type; Secondary cardiac amyloidosis - AA type; Stiff heart syndrome; Senile amyloidosis

Causes:

Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis.

Cardiac amyloidosis ("stiff heart syndrome") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heart beats (arrhythmias) and faulty heart signals (heart block).

Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40.

Symptoms:

Some patients may have no symptoms. When present, symptoms may include:

Treatment:

Your doctor may tell you to make changes to your diet, including limiting salt and fluids.

You may need to take water pills (diuretics) to help your body get rid of excess fluid. The doctor may tell you to weigh yourself every day. A weight gain of 3 or more pounds over 1 - 2 days can mean there is too much fluid in the body.

Medicines including digoxin, calcium channel blockers, and beta blockers may be used in people with atrial fibrillation. However, the drugs must be used with caution, and the dosage must be carefully monitored. People with cardiac amyloidosis may be extra sensitive to side effects of these drugs.

Other treatments may include:

  • Chemotherapy
  • Implantable cardioverter-defibrillator (AICD)
  • Pacemaker, if there are problems with heart signals
  • Prednisone, an anti-inflammatory medicine

A heart transplant may be considered for people with some types of amyloidosis who have very poor heart function. People with hereditary amyloidosis may need a liver transplant.

Outlook (Prognosis):

Cardiac amyloidosis is a long-term (chronic) condition that slowly gets worse. The life expectancy for people with cardiac amyloidosis averages less than 1 year.

Possible Complications:
When to Contact a Medical Professional:

Call your health care provider if you have this disorder and develop new symptoms such as:

  • Dizziness when you change position
  • Excessive weight (fluid) gain
  • Excessive weight loss
  • Fainting spells
  • Severe breathing problems
References:

Hare JM. The dilated, restrictive, and infiltrative cardiomyopathies. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 68.

McKenna W. Diseases of the myocardium and endocardium. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 60.


Review Date: 5/13/2014
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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