Primary Cardiac Amyloidosis: An Angiocardiographic Clue to Early Diagnosis

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Abstract
Restrictive cardiomyopathy produced by primary cardiac amyloidosis may have a clinical syndrome identical to noncalcific constrictive pericarditis. We report two patients with amyloidosis and restrictive physiology who had enlarged papillary muscles shown on left ventricular angiocardiogram. Rapid volume expansion with normal saline failed to produce ventricular filling pressure equilibration as in occult constrictive pericarditis. The absence of diastolic pressure equilibration and enlarged papillary muscles may permit early diagnosis of cardiac amyloidosis.