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[Cardiac manifestations of Fabry's disease]
Zhi-Hong Han1, Teng-Yong Jiang, Xue-Jun Ren
1Department of Cardiology, Beijing Anzhen Hospital, Affiliated to the Capital Medical University, Beijing, China.
Insights
Fabry disease, a rare genetic disorder, often presents with unrecognized cardiac issues. Early recognition of cardiac symptoms, family history, and multisystemic involvement aids diagnosis.
Area of Science:
- Genetics
- Cardiology
- Rare Diseases
Background:
- Fabry disease is an X-linked recessive disorder.
- Cardiac manifestations are often overlooked in Fabry disease.
Observation:
- Three female patients from Chinese kindreds with Fabry disease and cardiac symptoms were analyzed.
- Patients aged 41-57 presented with a family history of Fabry disease and cardiac symptoms.
- ECG revealed ST-T changes, and echocardiography showed left ventricular hypertrophy.
Findings:
- All patients exhibited low white blood cell alpha-galactosidase (alpha-GAL) levels.
- The patient with the most severe cardiac and multisystemic involvement had the lowest alpha-GAL level.
- Typical Fabry disease symptoms were noted in two patients during their youth.
Implications:
- Cardiac involvement should be considered in Fabry disease diagnosis.
- Family history, early-onset symptoms, and multisystemic signs are crucial diagnostic clues.
- This study highlights the importance of recognizing cardiac manifestations in Fabry disease.
Objective:
Fabry' s disease is a rare X-linked recessive disease. Its cardiac manifestations are not well recognized.
Methods:
The data of 3 patients from different Chinese kindreds with Fabry's disease and cardiac manifestations who seeked medical advice in our department in 2007 were analyzed. The age, sex, family history, main symptoms, ECG and echocardiographic findings were recorded for all the patients. The diagnostic criteria of Fabry's disease was based on alpha-galactosidase (alpha-GAL) quantity in white blood cells.
Results:
All of the patients were female. Their age was from 41 to 57. Two of them had the typical symptoms of Fabry's disease in their young age. All of them had family history of the disease and cardiac symptoms. ECG showed ST-T change and echocardiography showed hypertrophy of left ventricule of different degrees. Their alpha-galactosidase level in white blood cells was lower than normal. The alpha-galactosidase level in patient 1 was the lowest. Her cardiac symptoms were most serious in the three patients and she had involvement of other organs.
Conclusion:
Patients with Fabry's disease may have cardiac manifestations. Family history, typical symptoms in young age and the characteristics of multisystemic disorder are helpful clues to the diagnosis.
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