2014 ESC GUIDELINES OF HYPERTROPHIC MYOCARDIOPATHY SAYS: Differential diagnosis between HCM and cardiac amyloidosis is aided by measuring the ratio between QRS voltages and LV wall thickness.
I ask: How do you do the measure of ratio of voltage and wall thickness in myocardiopathies? The sum of all voltages of all leads (Positive and negative deflections)? Only precordials? Only frontals? Ratio by: Septal and wall thickness? LV mass? And the value:
Ok Sanjay good but only Sokolow-Lyon over thickness don't answer completely ESC post about this.
Great your post
Thanks
great question but there is no answer. Cardiomyopathies differ in their histology. Some have hypertrophy, some are infiltrative. Both will have increased wall thickness. We now have the capability to differentiate with MRI. This is a study that needs to be done. At what point of deviation from echo wall thickness and ECG Voltage (preferrably using Cornell) should we raise concern about infiltrative disease. Of course the question may be obviated by the ESC recommendation that MR is our first diagnostic imaging study.
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