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Navigating the Diagnostic and Management Challenges of Suspected Cardiac Amyloidosis in Resource-Limited Settings:

Sura Markos1, Yegzeru Belete2, Betre Bikamo3

  • 1Division of Cardiology, Department of Internal Medicine, College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia.

Clinical Case Reports
|November 20, 2024
PubMed

Insights

Diagnosing cardiac amyloidosis (CA) in resource-limited settings is complex. Limited provider awareness in Ethiopia leads to delayed diagnosis and treatment for heart failure patients with CA.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Medical Diagnostics

Background:

  • Cardiac amyloidosis (CA) presents diagnostic and therapeutic challenges, particularly in resource-limited healthcare settings.
  • Delayed diagnosis of CA can result from limited awareness among primary healthcare providers, leading to misdiagnosis and suboptimal management.
  • Ethiopia faces specific hurdles in identifying and treating CA, impacting patient outcomes.

Purpose of the Study:

  • To highlight the diagnostic and therapeutic complexities of cardiac amyloidosis in resource-limited environments.
  • To illustrate the challenges through a specific case presentation from Ethiopia.
  • To emphasize the need for improved diagnostic capabilities and provider education for CA.

Main Methods:

  • Case report detailing a patient's diagnostic journey over 13 months with multiple physician visits.
  • Analysis of clinical presentation, electrocardiographic (ECG) and echocardiographic findings, and cardiac troponin levels.
  • Discussion of diagnostic discrepancies and challenges in a resource-limited context.

Main Results:

  • A patient with heart failure symptoms was diagnosed with cardiac amyloidosis after a prolonged period.
  • Discrepancies between ECG and echocardiography, along with elevated troponin, were key diagnostic clues.
  • Limited awareness of CA among Ethiopian primary healthcare providers contributed to diagnostic delays.

Conclusions:

  • Heightened clinical suspicion is crucial for diagnosing cardiac amyloidosis in resource-limited settings.
  • Proficiency in recognizing characteristic ECG and echocardiographic findings is essential for early detection.
  • Prompt referral to cardiologists and improved diagnostic resources are vital for effective CA management.

Keywords:
Ethiopiaamyloidosiscardiac amyloidosisresource limitedrestrictive cardiomyopathy

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