What is the role of endomyocardial biopsy (EMB) in the workup of cardiac amyloidosis?

Updated: Mar 25, 2020
  • Author: Gyanendra K Sharma, MD, FACC, FASE; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Electromyocardia biopsy (EMB) is considered the criterion standard for diagnosis. Amyloid tissue, when stained with Congo red, appears as an amorphous pink deposit under light microscopy and has a green-apple birefringence under polarized microscopy. Sulfated Alcian blue can be used as an alternative stain with a high specificity for the diagnosis of amyloidosis. EMB has a great sensitivity (almost 100%) due to the diffuse cardiac involvement and is a safe procedure in experienced hands. EMB is also of a great value in differentiating cardiac amyloidosis from other infiltrative myocardial conditions. [69, 70, 71]


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