POSTMORTEM DIAGNOSIS OF CARDIAC AMYLOIDOSIS IN THE ELDERLY - CLINICOPATHOLOGICAL CORRELATIONS

The absence of specific clinical signs makes the diagnosis of cardiac amyloidosis difficult. Moreover, it is established that this condition , the prevalence of which increases with age, aggravates the prognosis of cardiac failure. Tne present study was undertaken to identify the clinical or paraclinical signs enabling more accurate diagnosis of thi s disease. Analysis of 2589 autopsy reports from the University Instit utes of Geriatrics of Geneva between January 1972 and January 1990 rec ensed 58 cases of microscopic cardiac amyloidosis, but this diagnosis was not made in any of these patients before death. Of the potential i ndicators, the good specificty but poor sensitivity of atrial fibrilla tion and low voltage electrocardiogramme was confirmed. On the other h and, the author's research found the association of radiological cardi omegaly and a raised erythrocyte sedimentation rate in nearly 70 % of cases of cardiac amyloidosis with a false positive rate of only 10 % i n a control group.