Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.742
Peer-review started: January 10, 2019
First decision: January 26, 2019
Revised: February 12, 2019
Accepted: February 18, 2019
Article in press: February 18, 2019
Published online: March 26, 2019
Cardiac amyloidosis, a disease caused by the precipitation of amyloid proteins in the myocardial extracellular matrix has been historically difficult to diagnose due to lack of specific clinical manifestations and necessity of biopsy to demonstrate amyloid deposition. However, advances in cardiovascular imaging techniques have facilitated earlier recognition of this disease. In addition, while once thought of as incurable, treatment strategies are emerging for cardiac amyloidosis, making early diagnosis essential.
We outline the case of a 73 years old African American female who was admitted with sudden onset shortness of breath and found to be in cardiogenic shock. Cardiac amyloidosis was suspected due to discordance between electrocardiogram and echocardiogram findings and this was subsequently confirmed with the aid of scintigraphy and an endomyocardial biopsy.
Our objective is to highlight the diagnostic evaluation and clinical implications of cardiac amyloidosis.
Core tip: Modern cardiovascular imaging techniques have facilitated earlier identification of cardiac amyloidosis, an important but under diagnosed cause of restrictive cardiomyopathy and heart failure. Early diagnosis is key as treatment strategies are emerging which have the potential to alter the disease course.