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[Cardiac Amyloidosis: Experience in a National Reference Cardiovascular Institute]
Juan Muñoz-Moreno1, José Añorga-Ocmin1, Sandra Espinola-García1
1Médico residente de Cardiología. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú. Instituto Nacional Cardiovascular - INCOR EsSalud Lima Perú.
Insights
Cardiac amyloidosis patients often present with heart failure and neuropathy. This study found a 25% one-year mortality rate, with sudden death being the primary cause in cardiac amyloidosis cases.
Area of Science:
- Cardiology
- Cardiovascular Diseases
- Amyloidosis
Context:
- Cardiac amyloidosis is a progressive condition often diagnosed late.
- Understanding its clinical presentation and outcomes is crucial for patient management.
- This study examines patients within a national reference hospital setting.
Purpose:
- To determine the clinical, imaging, and laboratory characteristics of cardiac amyloidosis.
- To assess the one-year survival rate of patients diagnosed with cardiac amyloidosis.
- To identify the primary causes of mortality in this patient cohort.
Summary:
- A case series of eight cardiac amyloidosis patients revealed a median age of 64.5 years, with 75% being male.
- Transthyretin and light chain amyloidosis were the most common etiologies (37.5% each).
- Heart failure (87.5%) and sensory-motor neuropathy (62.5%) were the most frequent manifestations. One-year survival was 75%, with sudden death causing both fatalities.
Impact:
- Highlights the significant clinical manifestations and high mortality rate of cardiac amyloidosis.
- Emphasizes the importance of early diagnosis and management of cardiac amyloidosis.
- Provides valuable data on survival and causes of death in cardiac amyloidosis patients.
Objectives:
To determine the clinical, imaging and laboratory characteristics and one year after diagnosis survival of patients with cardiac amyloidosis in a national reference hospital.
Materials And Methods:
Case series study. We evaluated the clinical characteristics, complementary examinations and survival of patients with cardiac amyloidosis diagnosed, treated and followed up in the Clinical Cardiology service of the National Cardiovascular Institute - INCOR EsSalud in Lima, Peru.
Results:
We found eight patients with diagnosis of cardiac amyloidosis. The median age was 64.5 years and 75% were male. The etiology of cases was unspecified cardiac amyloidosis (25%), transthyretin cardiac amyloidosis (37.5%), and light chain cardiac amyloidosis (37.5%). Symptomatic heart failure (NYHA II-III) was the most common initial presentation symptom (87.5%). The most frequent extracardiac manifestations were: sensory-motor neuropathy (62.5%), musculoskeletal (37.5%), nephropathy (25%), bilateral carpal tunnel syndrome (25%), monoclonal gammopathies (25%) and refractory pleural effusion (25 %). Survival at one year was 75% and the cause of the 2 deaths was sudden death.
Conclusions:
In this study of cardiac amyloidosis at a specialized center, the most frequent clinical manifestations were heart failure and sensory-motor neuropathy. Mortality was 25% per year, and in all cases as sudden death.
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