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Systemic amyloidosis presenting with angina pectoris.

J Al Suwaidi1, J L Velianou, M A Gertz

  • 1Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, MN 55905, USA.

Annals of Internal Medicine
|December 28, 1999
PubMed
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Systemic amyloidosis can rarely cause angina pectoris, even with normal coronary angiograms. This condition involves coronary flow reserve abnormalities and intramyocardial vessel amyloid deposition.

Area of Science:

  • Cardiology
  • Amyloidosis Research
  • Vascular Medicine

Background:

  • Cardiac amyloidosis commonly presents as congestive heart failure or sudden cardiac death.
  • Vascular involvement is frequent in amyloidosis, but angina is an uncommon presentation.
  • Systemic amyloidosis can manifest with cardiac symptoms.

Purpose of the Study:

  • To describe patients with systemic amyloidosis who presented with angina pectoris.
  • To highlight angina as a rare initial manifestation of systemic amyloidosis.

Main Methods:

  • A case series design was employed.
  • The study was conducted at an academic medical center.
  • Five patients with angina pectoris and normal coronary angiograms were evaluated.

Related Experiment Videos

Main Results:

  • All patients exhibited coronary flow reserve abnormalities.
  • Amyloid deposition was found in intramyocardial coronary vessels.
  • Patients later developed congestive heart failure and systemic amyloidosis.

Conclusions:

  • Cardiac amyloidosis may present as angina pectoris with coronary flow reserve abnormalities despite normal coronary angiograms.
  • This presentation has significant therapeutic and prognostic implications.
  • Early recognition of cardiac amyloidosis presenting as angina is crucial.