Cardiac amyloidosis presenting with coronary artery embolization
Christos Papageorgiou1, Eleftheria Tsagalou2, Ioannis Baraboutis3
1Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Reviews in Cardiovascular Medicine
|September 26, 2021
Summary
Amyloid light-chain amyloidosis can cause ST-elevation myocardial infarction through coronary artery embolization. Early diagnosis and multidisciplinary care are crucial for managing this rare cardiovascular complication.
Area of Science:
- Cardiology
- Oncology
- Hematology
Background:
- Amyloid light-chain (AL) amyloidosis is a systemic disease with varied clinical presentations.
- Thromboembolic events, including arterial events, are known manifestations of AL amyloidosis.
Observation:
- A 57-year-old female presented with ST-elevation myocardial infarction (STEMI).
- Coronary angiography revealed embolization in the left anterior descending artery.
- Cardiac imaging showed left ventricular hypertrophy, impaired systolic function, and restrictive filling patterns.
Findings:
- Cardiac magnetic resonance imaging indicated microvascular infarction and apex infarct, suggestive of amyloidosis.
- Fat tissue biopsy confirmed AL amyloidosis.
- The patient received anticoagulation, heart failure therapy, and anti-plasma cell treatment.
Implications:
- Amyloidosis should be considered in the differential diagnosis of coronary artery embolization and myocardial infarction.
- Multidisciplinary collaboration between cardiologists and oncologists is essential for accurate diagnosis and management.
- Prompt treatment led to clinical improvement and freedom from cardiovascular events for 12 months.
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