[Significance of electro- and echocardiogram for the diagnosis of cardial amyloidosis].

The cause of severe right heart failure and of equal diastolic pressures in both ventricles (as seen in constrictive pericarditis) in a 56-year-old woman was suspected to be cardiac amyloidosis on the basis of findings in both the echocardiogram (biventricular hypertrophy) and the electrocardiogram (prominent Q waves, absent hypertrophy signs). The endomyocardial biopsy was at first unremarkable. But later, serial modified Congo-red staining unequivocally demonstrated amyloid deposits. In a second case, a 66-year-old man with global cardiac failure and echocardiographic pointers towards hypertrophic cardiomyopathy, was treated with verapamil, 240 mg daily. When this was not tolerated he was hospitalized. He, too, had prominent Q waves but no signs of ventricular hypertrophy. Cardiac amyloidosis was confirmed by biopsy. Both cases underline the special importance of echo- and electrocardiographic changes, taken together, in the diagnosis of cardiac amyloidosis.