Endomyocardial biopsy is valuable for diagnosing left ventricular hypertrophy when cardiac amyloidosis is suspected, especially if non-invasive imaging like technetium-99m-pyrophosphate scintigraphy is false-negative.
This report describes the unusual presentation of a patient with primary cardiac amyloidosis. Initial clinical symptoms and hemodynamic studies, including Technetium‐99m‐ pyrophosphate scintigraphy, suggested hypertrophic obstructive cardiomyopathy, but endomyocardial biopsy revealed diffuse amyloid infiltration. Only two other cases of left ventricular outflow tract obstruction due to cardiac amyloidosis have been reported. The false‐negative technetium‐99m‐pyrophosphate scintigram in this patient argues for the use of endomyocardial biopsy to aid in the diagnosis of left ventricular hypertrophy.
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Weston et al. (1986) studied this question.
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