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Published on: August 16, 2021
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Cardiac amyloid presenting as cardiogenic shock: case series
Monique Oye1, Pooja Dhruva1, Fadi Kandah1
1Department of Internal Medicine, Internal Medicine Resident, UF Health Jacksonville, 655, W 8th street, Jacksonville, FL 32209-6595, USA.
European Heart Journal. Case Reports
|August 11, 2021
Summary
Cardiac amyloidosis, a serious infiltrative disease, can present as cardiogenic shock, particularly in African-American patients. Early diagnosis is crucial for better outcomes, as delayed detection often leads to fatal results despite aggressive treatment.
Area of Science:
- Cardiology
- Nephrology
- Hematology
Background:
- Amyloidosis is a systemic disease caused by misfolded protein deposition.
- Cardiac involvement significantly worsens prognosis in amyloidosis patients.
Observation:
- Two African-American patients presented with cardiac amyloidosis leading to cardiogenic shock.
- Missed diagnostic opportunities occurred prior to their critical presentations.
- One patient had light-chain amyloidosis with preserved ejection fraction; the other had transthyretin amyloidosis with reduced ejection fraction.
Findings:
- Cardiac amyloidosis can mimic common heart failure causes, especially in African-Americans.
- Presentation as cardiogenic shock indicates a poor prognosis, often rapidly fatal.
- Aggressive treatments were insufficient to prevent fatal outcomes in these cases.
Implications:
- Increased awareness and earlier diagnostic strategies for cardiac amyloidosis are vital.
- Timely diagnosis can potentially alter the typically fatal course of the disease.
- This case series highlights diagnostic challenges and the critical need for prompt recognition in at-risk populations.
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