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Interactions with and Membrane Permeabilization of Brain Mitochondria by Amyloid Fibrils
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Amyloidosis and the Syncopal Enigma.

Brittany Strelow1, Hayden Middleton2, Kathleen A Young1

  • 1Mayo Clinic, Rochester, MN, USA.

Journal of Primary Care & Community Health
|December 16, 2024
PubMed
Summary
This summary is machine-generated.

Syncope evaluation requires careful history taking to identify cardiac causes. Cardiac amyloidosis, though rare, can cause syncope and warrants consideration in diagnosis.

Keywords:
arrhythmiasfamily medicinegeneral practiceprimary caresyncope

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Syncope is a frequent outpatient complaint necessitating detailed history to differentiate cardiac from non-cardiac causes.
  • Accurate diagnosis relies heavily on healthcare professionals' meticulous approach to patient evaluation.

Observation:

  • A 76-year-old male presented with syncope, prompting suspicion of a cardiac origin.
  • Initial investigations including ECG and Holter monitoring did not reveal sustained arrhythmias.
  • A dobutamine stress echocardiogram was negative for ischemia, but resting echocardiography suggested cardiac amyloidosis.

Findings:

  • Transthyretin (ATTR) cardiac amyloidosis was confirmed as the cause of syncope.
  • The patient received treatment for ATTR cardiac amyloidosis and a dual-chamber implantable cardioverter defibrillator (ICD).

Implications:

  • Cardiac amyloidosis is an important, albeit rare, differential diagnosis for cardiogenic syncope.
  • Comprehensive cardiac structural evaluation is essential when syncope suggests a cardiac etiology.
  • This case underscores the need for a broad diagnostic approach to syncope in clinical practice.