Vol 15, No 1 (2020)
Case report
Published online: 2020-02-27
Echo solves clinical puzzle — cardiac amyloidosis case report
DOI: 10.5603/FC.2020.0008
Folia Cardiol 2020;15(1):61-63.
Abstract
We present the case of a 53-year-old woman with New York Heart Association (NYHA) class III heart failure, despite optimal pharmacological therapy. Her medical history included: myocardial infarction with nonobstructive coronary arteries (MINOCA), heart failure with reduced ejection fraction and quadrantanopia with sensory neuropathy diagnosed as ischaemic stroke. Transthoracic echocardiography showed significant left ventricular hypertrophy with a ‘granular’ myocardial texture, global systolic dysfunction and restrictive mitral filling pattern. Two-dimensional (2D) transthoracic echo strain analysis demonstrated decreased global longitudinal strain with apical sparing, and helped to fit all the pieces of the jigsaw together to reach a consistent clinical diagnosis of cardiac amyloidosis.
Keywords: 2D transthoracic echocardiographycardiac amyloidosisspeckle tracking echocardiography
References
- Shah KB, Inoue Y, Mehra MR. Amyloidosis and the heart: a comprehensive review. Arch Intern Med. 2006; 166(17): 1805–1813.
- Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation. 2005; 112(13): 2047–2060.
- Falk RH, Quarta CC. Echocardiography in cardiac amyloidosis. Heart Fail Rev. 2015; 20(2): 125–131.
- Phelan D, Collier P, Thavendiranathan P, et al. Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis. Heart. 2012; 98(19): 1442–1448.
