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Systemic Amyloidosis With Probable Cardiac Involvement: Diagnostic Approach in a Resource-Limited Setting: A Case

Malegna Temesgen Garuma1, Yonatan Debebe Regassa2, Sifessa Dessalegn Demshasha1

  • 1Department of Internal Medicine St. Paul's Hospital Millennium Medical College Addis Ababa Ethiopia.

Clinical Case Reports
|July 10, 2026
PubMed

Insights

Systemic amyloidosis, a heart condition, is often missed in resource-limited areas. This case shows how basic tests and biopsy can diagnose cardiac involvement, improving patient outcomes.

Area of Science:

  • Cardiology
  • Pathology
  • Internal Medicine

Background:

  • Systemic amyloidosis is an infiltrative cardiomyopathy frequently underdiagnosed, especially in resource-limited settings.
  • Limited access to advanced diagnostics hinders timely diagnosis and subtyping of amyloidosis.

Purpose of the Study:

  • To present a case of systemic amyloidosis with cardiac involvement diagnosed in a resource-limited setting.
  • To highlight an integrated diagnostic approach using basic clinical findings and minimally invasive biopsy.

Main Methods:

  • A 57-year-old man with heart failure with preserved ejection fraction (HFpEF) underwent clinical evaluation, electrocardiography, and echocardiography.
  • An abdominal fat pad biopsy with Congo red staining was performed to confirm amyloid deposition.
  • Diagnosis was made despite unavailability of advanced tests like serum protein electrophoresis and free light-chain assay.

Main Results:

  • Electrocardiography showed low-voltage QRS complexes, while echocardiography revealed left ventricular hypertrophy and diastolic dysfunction.
  • A discrepancy between ECG and echo findings suggested infiltrative cardiomyopathy.
  • Abdominal fat pad biopsy confirmed amyloid deposition, establishing the diagnosis of systemic amyloidosis with cardiac involvement.

Conclusions:

  • Basic clinical data, ECG, echocardiography, and biopsy can diagnose cardiac amyloidosis in resource-limited settings.
  • Amyloid subtyping is crucial for targeted therapy but often unavailable.
  • Early recognition and appropriate management are key to improving outcomes for patients with cardiac amyloidosis.

Keywords:
cardiac amyloidosiscase reportheart failure with preserved ejection fractionrestrictive cardiomyopathysystemic amyloidosis

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