"A case of cardiac amyloidosis with syncope"

A 56 year gentleman referred to our hospital for evaluation of syncope. He was seen previously at a local clinic and treated for cardiac failure with diuretics and was doing well on medication. He started having recurrent episode of syncope. He had his last visit to the local physician three days prior to admission when he had palpitation and was prescribed digoxin in addition to the usual medicine. Patient started having syncope from 3rd day and was referred to our hospital for evaluation. Patient's electrocardiogram as well as echocardiography was a classical finding of cardiac amyloidosis and a fat pad biopsy confirmed the diagnosis. After withdrawing digoxin and after two days on pacemaker, the patient regained normal heart rate and was discharged on diuretics.