Related Experiment Video

Updated: Aug 15, 2026

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
14:19

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Published on: October 14, 2016

Obstructive intramural coronary amyloidosis and myocardial ischemia are common in primary amyloidosis

Michelle A Neben-Wittich1, Christopher M Wittich, Paul S Mueller

  • 1Department of Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.

The American Journal of Medicine
|November 8, 2005
PubMed

Insights

Most patients with cardiac amyloidosis have obstructive intramural coronary amyloidosis, leading to myocardial ischemia. This condition can manifest as heart attacks or angina, sometimes being the first sign of primary amyloidosis.

Area of Science:

  • Cardiology
  • Pathology
  • Amyloidosis Research

Background:

  • Primary systemic amyloidosis frequently involves the heart.
  • Cardiac involvement can lead to heart failure and arrhythmias.
  • Coronary artery pathology in cardiac amyloidosis is not fully understood.

Purpose of the Study:

  • To determine the prevalence of obstructive intramural coronary amyloidosis in patients with primary amyloidosis and cardiac involvement.
  • To investigate the association between obstructive intramural coronary amyloidosis and myocardial ischemia.
  • To identify clinical syndromes of myocardial ischemia in this patient population.

Main Methods:

  • Retrospective review of medical records and pathologic specimens from 96 patients with primary amyloidosis and cardiac involvement.
  • Analysis of autopsy or cardiac transplantation cases over a 20-year period.
  • Examination for obstructive intramural coronary amyloidosis and microscopic ischemic changes.

Main Results:

  • Obstructive intramural coronary amyloidosis was found in 66% of patients.
  • Microscopic myocardial ischemia was significantly more common in patients with obstructive intramural coronary amyloidosis (86%) versus without (52%).
  • Syndromes of myocardial ischemia occurred in 25% of patients with obstructive intramural coronary amyloidosis, sometimes as the initial presentation of primary amyloidosis.

Conclusions:

  • Obstructive intramural coronary amyloidosis is highly prevalent in patients with primary systemic amyloidosis and cardiac involvement.
  • Associated microscopic myocardial ischemia is common.
  • Clinical syndromes of myocardial ischemia are a recognized complication.
Abstract

More Related Videos

Coronary Artery Ligation and Intramyocardial Injection in a Murine Model of Infarction07:41

Coronary Artery Ligation and Intramyocardial Injection in a Murine Model of Infarction

Published on: June 7, 2011

Related Concept Videos

Myocarditis I: Introduction01:21

Myocarditis I: Introduction

Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
Amyloid Fibrils03:03

Amyloid Fibrils

Amyloid fibrils are aggregates of misfolded proteins.  Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils. 
Amyloid deposits were observed as early as 1639 in the liver and the spleen.   In 1854, Rudolph Virchow performed iodine staining, normally used to...
Amyloid Fibrils03:03

Amyloid Fibrils

Amyloid fibrils are aggregates of misfolded proteins.  Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils. 
Amyloid deposits were observed as early as 1639 in the liver and the spleen.   In 1854, Rudolph Virchow performed iodine staining, normally used to...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...