Cardiac amyloidosis

Case contributed by Dr David Cuevas

Presentation

Female patient with symptoms of congestive heart failure.

Patient Data

Age: 60 years
Gender: Female
MRI

Diastolic dysfunction and diffuse global LGE (late gadolinium enhancement), consistent with amyloidosis.

Hypokinesis and hypertrophy of both ventricles, LVEF 48.9%, FEVD: 39.1%.

Severe tricuspid and mild mitral insufficiency, plus dilation of both atria.

Pericardial and right pleural effusion.

NB: LGE and thick atrial septum (7 mm).

Case Discussion

Cardiac involvement in amyloidosis disease denotes the deposition of amyloid fibril in the heart. As in this case, there is a progressive increase in the thickness of the walls that causes the symptoms of heart failure, such as dyspnea and edema.
Although the gold standard is endomyocardial biopsy with immunostaining, cardiac MRI is very sensitive for infiltrative cardiomyopathy and is used for measuring the thickness of the left ventricular walls. Additionally, the use of gadolinium has the ability to distinguish between different types of cardiomyopathy.

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Case information

rID: 61600
Published: 13th Jul 2018
Last edited: 14th Aug 2019
System: Cardiac
Inclusion in quiz mode: Included
Institution: Instituto Nacional de Cardiología

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