PRIMARY AMYLOIDOSIS AND SYNCOPE

A 59-year-old caucasian consulted our clinic with symptoms of dizzines s and exertional syncope. The combination of myocardial hypertrophy di agnosed by echocardiography, together with a history of peripheral neu ropathy made us suspect cardiac amyloidosis which was later proven by endomyocardial biopsy. A graded exercise test and two Holter monitorin g studies revealed neither rhythm nor conduction abnormalities. A head -up tilt test revealed a vasovagal vasodepressor response. Copyright ( C) 1997 Elsevier Science Ireland Ltd.