Cardiac amyloidosis: A case report and review of literature

Figure 1 Electrocardiogram – Left bundle branch block with low voltage in limb leads.

Figure 2 Parasternal long axis echocardiographic view demonstrating severe concentric left ventricular hypertrophy with small pericardial effusion.

Figure 3 Short axis echocardiographic view demonstrating severe concentric left ventricular hypertrophy with small pericardial effusion.

Figure 4 Four chamber echocardiographic view demonstrating bi atrial enlargement, left ventricular hypertrophy, small pericardial effusion and implantable cardioverter-defibrillator device.

Figure 5 Doppler demonstrating restrictive physiology with medial E’ velocity of 2. 78 cm/s and E/Med E’ 39.2.

Figure 6 Doppler demonstrating restrictive physiology with lateral E’ velocity of 3. 07cm/s and E/Lat E’ 35.5.

Figure 7 Planar scintigraphy using ⁹⁹Technetium pyrophosphate for detection of amyloid protein in the heart. Quantitative analysis of heart retention (done 4 h after injection of ⁹⁹Technetium pyrophosphate) showed a heart to contralateral (H/CL) ratio of 1.8 (a ratio of > 1.5 is considered to strongly suggest ATTR amyloid deposition).