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Cardiac amyloidosis as a rare cause of heart failure: A case report

Ming Gao1, Quan Liu1, Liping Chen2

  • 1Department of Cardiology.

Medicine
|April 5, 2019
PubMed

Insights

Cardiac amyloidosis, a rare condition, presents with varied symptoms. Early consideration is crucial for patients with unexplained heart failure, as diagnosis and treatment remain challenging, impacting prognosis.

Area of Science:

  • Cardiology
  • Hematology
  • Oncology

Background:

  • Cardiac amyloidosis is a rare, challenging diagnosis due to nonspecific symptoms.
  • Prognosis is determined by cardiac involvement; heart failure indicates poor survival.
  • Optimal treatment strategies for cardiac amyloidosis are not yet established.

Observation:

  • A 50-year-old male presented with progressive dyspnea following pneumonia.
  • ECG showed poor R-wave progression and low voltage; echocardiography revealed left ventricular hypertrophy and diastolic dysfunction.
  • Fat aspirate confirmed amyloidosis; bone marrow showed benign monoclonal gammopathy.

Findings:

  • Serum free light-chain analysis revealed elevated lambda chains.
  • A Congo red stain on bone marrow biopsy was negative.
  • Treatment with bortezomib, cyclophosphamide, and dexamethasone was initiated.

Implications:

  • Cardiac amyloidosis must be suspected in adults with cardiac distress or heart failure.
  • Prompt diagnosis and consideration of underlying restrictive cardiomyopathy are vital.
  • This case highlights the diagnostic difficulties and poor outcomes associated with advanced cardiac amyloidosis.
Abstract

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