What are the echocardiogram (echo) findings of deposits in the heart?

From the Guidelines

Echocardiogram findings of deposits in the heart typically include LV wall thickening, small LV cavity size, biatrial enlargement, thickened valves, elevated right ventricular systolic pressure and atrial septum thickness, granular sparkling appearance of the myocardial wall, pericardial effusion, restrictive transmitral Doppler filling pattern, and reduced ventricular strain, as seen in transthyretin cardiac amyloidosis 1. The echocardiogram is a cost-effective and commonly available imaging technique that can identify diastolic dysfunction and is better than most other imaging techniques at doing so 1. Some key echocardiogram findings of deposits in the heart include:

• LV wall thickening
• Small LV cavity size
• Biatrial enlargement
• Thickened valves
• Elevated right ventricular systolic pressure and atrial septum thickness
• Granular sparkling appearance of the myocardial wall
• Pericardial effusion
• Restrictive transmitral Doppler filling pattern
• Reduced ventricular strain These findings are particularly useful in combination with ECG findings, such as low voltage, to increase clinical suspicion of transthyretin cardiac amyloidosis 1. It's worth noting that while echocardiography can provide valuable information about cardiac structure and function, other imaging modalities like cardiac magnetic resonance (CMR) and myocardial scintigraphy may be necessary to confirm the diagnosis and differentiate amyloidosis from other wall-thickening disorders 1.

From the Research

Echocardiogram Findings of Deposits in the Heart

The echocardiogram findings of deposits in the heart, specifically in cardiac amyloidosis, include:

• Thickened right and left ventricular (LV) myocardium 2
• Normal or small LV cavity size in contrast to enlarged biatrial cavities 2
• Diffuse hyper-refractile 'granular sparkling' appearance 2
• 'Mismatch' ECG/ECHO 2
• Reduced magnitude of cyclic variation recorded with integrated backscatter, reflecting structural changes in the myocardium 2
• LV dysfunction, which can be assessed using the Tei index 2
• Abnormal LV longitudinal function and cyclic variation of myocardial integrated backscatter, which may be predictors of adverse outcomes 3

Calcific Deposits in the Heart

Calcific deposits in the heart can be found in various patterns, including:

• Valvular calcific deposits 4
• Myocardial calcific deposits 4
• Intracavitary calcific deposits 4
• Coronary calcific deposits 4 These deposits can be described using simple descriptive terms such as "myocardial calcific deposits" 4, and can be diagnosed using ultrafast (cine) computed tomography 4

Echocardiographic Techniques

New echocardiographic techniques, such as:

• Tissue Doppler 2
• Doppler-based strain 2
• Speckle tracking imaging 2
• Three-dimensional echocardiography 2
• Fully automated echocardiogram interpretation 3 can provide further useful information for assessing cardiac function and prognosis in cardiac amyloidosis patients.