Vascular-variant cardiac amyloid: Cardiac MRI and histopathological appearances

Cardiac amyloidosis is an infiltrative cardiomyopathy caused by the deposition of abnormally folded proteins within the myocardium. Several amyloid subtypes have been documented, with diagnosis supported by abnormal serum plasma electrophoresis, multimodality imaging, and endomyocardial biopsy. Herein, we describe the atypical MRI findings of vascular-variant cardiac amyloid supported by histopathological diagnosis. Knowledge of the vascular-variant cardiac amyloid, in which amyloid deposits in the myocardial vasculature rather than the interstitium, will enable clinicians to proceed down appropriate diagnostic and treatment pathways.