Amyloid heart disease

Abstract

Twenty-eight cases of cardiac amyloidosis were observed on reviewing 21,300 postmortem examinations performed at Barnes Hospital between 1916 and 1962. Five of these have been presented in detail. The clinical, electrocardiographic and in some instances vectorcardiographic findings have been correlated with the postmortem findings of cardiac amyloidosis. Pertinent antemortem features are described which may permit a more accurate diagnosis of amyloid heart disease; particularly the combination of left axis deviation of QRS, low QRS voltage in the limb leads, a QS configuration and/or small R waves in V 1 to V 3, with or without atrial fibrillation, occurring in the electrocardiogram of elderly patients in intractable congestive heart failure without a history of heart disease.