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[The rapid progress of heart failure due to systemic amyloidosis with cardiac involvement--case report].
Przegl Lek. 2015; 72(11):697-700.PL

Abstract

Amyloidosis is a disease having many different faces. Different symptoms may appear, depending on which organ is involved. That's why correct diagnosis can be difficult. Cardiac involvement must always be considered because of poor prognosis (30 to 68 % patients survive one year). Also in case of rapid progress of cardiac wall thickening, amyloidosis should be taken into account.

MATERIAL AND METHODS

we present a case of a female patient with rapid progress of heart failure due to systemic amyloidosis with cardiac involvement.

CASE REPORT

48-old female, with no prior medical history, admitted to cardiology ward because of dyspnea on exertion and leg edema. Couple days before admission hypertrophic cardiomyopathy was diagnosed. Laboratory test revealed elevated troponin I, d-dimers and BNP (natriuretic peptide type B). Electrocardiogram showed low QRS voltage in limb leads. Echocardiography confirmed concentric thickening of left ventricular walls and reduced ejection fraction (40%). We performed cardiac magnetic resonance. Morphology of the delayed enhancement and an increased signal in T2 dependent sequences suggested overlap of general inflammatory process and hypertrophic cardiomyopathy. Because of amyloidosis suspicion, gingival and subcutaneous adipose tissue biopsies were performed. Sirius red stain identified amyloid only in the walls of gingival blood vessels. Diagnosis of amyloidosis was established and further diagnostics planned. Soon after patients condition worsened. Finally, in intensive care unit, after cardiac arrest patient died.

CONCLUSION

Amyloidosis with cardiac involvement has a very poor prognosis. Multiple tissue biopsy and histopathological assessment should lead to correct diagnosis and proper treatment.

Authors

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Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

pol

PubMed ID

27012134

Citation

Gilowski, Wojciech, et al. "[The Rapid Progress of Heart Failure Due to Systemic Amyloidosis With Cardiac Involvement--case Report]." Przeglad Lekarski, vol. 72, no. 11, 2015, pp. 697-700.
Gilowski W, Stryjewski P, Gilowska M, et al. [The rapid progress of heart failure due to systemic amyloidosis with cardiac involvement--case report]. Prz Lek. 2015;72(11):697-700.
Gilowski, W., Stryjewski, P., Gilowska, M., Liszniański, P., & Nowak, J. (2015). [The rapid progress of heart failure due to systemic amyloidosis with cardiac involvement--case report]. Przeglad Lekarski, 72(11), 697-700.
Gilowski W, et al. [The Rapid Progress of Heart Failure Due to Systemic Amyloidosis With Cardiac Involvement--case Report]. Prz Lek. 2015;72(11):697-700. PubMed PMID: 27012134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The rapid progress of heart failure due to systemic amyloidosis with cardiac involvement--case report]. AU - Gilowski,Wojciech, AU - Stryjewski,Piotr, AU - Gilowska,Małgorzata, AU - Liszniański,Piotr, AU - Nowak,Jacek, PY - 2016/3/26/entrez PY - 2015/1/1/pubmed PY - 2016/5/26/medline SP - 697 EP - 700 JF - Przeglad lekarski JO - Prz. Lek. VL - 72 IS - 11 N2 - UNLABELLED: Amyloidosis is a disease having many different faces. Different symptoms may appear, depending on which organ is involved. That's why correct diagnosis can be difficult. Cardiac involvement must always be considered because of poor prognosis (30 to 68 % patients survive one year). Also in case of rapid progress of cardiac wall thickening, amyloidosis should be taken into account. MATERIAL AND METHODS: we present a case of a female patient with rapid progress of heart failure due to systemic amyloidosis with cardiac involvement. CASE REPORT: 48-old female, with no prior medical history, admitted to cardiology ward because of dyspnea on exertion and leg edema. Couple days before admission hypertrophic cardiomyopathy was diagnosed. Laboratory test revealed elevated troponin I, d-dimers and BNP (natriuretic peptide type B). Electrocardiogram showed low QRS voltage in limb leads. Echocardiography confirmed concentric thickening of left ventricular walls and reduced ejection fraction (40%). We performed cardiac magnetic resonance. Morphology of the delayed enhancement and an increased signal in T2 dependent sequences suggested overlap of general inflammatory process and hypertrophic cardiomyopathy. Because of amyloidosis suspicion, gingival and subcutaneous adipose tissue biopsies were performed. Sirius red stain identified amyloid only in the walls of gingival blood vessels. Diagnosis of amyloidosis was established and further diagnostics planned. Soon after patients condition worsened. Finally, in intensive care unit, after cardiac arrest patient died. CONCLUSION: Amyloidosis with cardiac involvement has a very poor prognosis. Multiple tissue biopsy and histopathological assessment should lead to correct diagnosis and proper treatment. SN - 0033-2240 UR - https://www.unboundmedicine.com/medline/citation/27012134/[The_rapid_progress_of_heart_failure_due_to_systemic_amyloidosis_with_cardiac_involvement__case_report]_ L2 - http://www.diseaseinfosearch.org/result/380 DB - PRIME DP - Unbound Medicine ER -