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Isolated cardiac amyloidosis with normal interventricular septum thickness: a case report

Published online by Cambridge University Press:  25 April 2022

Zhanwen Xu
Affiliation:
Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
Yaqin Li*
Affiliation:
Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
*
Author for correspondence: Ya-qin Li, Department of Cardiology, Affiliated Hospital of Hebei University, Yuhua Road 212, Baoding 071000, China. Tel: +86-13903329568. E-mail: dannyxzw@163.com

Abstract

Cardiac amyloidosis presented with normal interventricular septum is an extremely rare entity, and diagnosis may be difficult. This report discusses a 44-year-old female who presented with worsening dyspnoea on exertion, orthopnoea, and lower-extremity oedema. Electrocardiogram depicted low voltage in limb leads and a pseudoinfarct pattern. Echocardiogram revealed biatrial dilatation without changes of ventricular chambers and restrictive filling physiology. A diagnosis of cardiac amyloidosis was considered. Cardiac MRI was pursued, showing delayed gadolinium enhancement, and this ultimately led to the myocardial biopsy confirming the diagnosis of cardiac amyloidosis. The case suggests that patients who present with heart failure of uncertain aetiology, amyloidosis could be a cause of cardiomyopathy despite the absence of “classical” echocardiographic features of amyloid deposition such as an increased interventricular septum thickness or“brilliant sparkled”appearance of the myocardium.

Type
Brief Report
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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