Cardiac amyloidosis masquerading as acute coronary syndrome
- Resource Type
- Authors
- Yong Yong Tew; Anne Scott
- Source
- BMJ Case Rep
- Subject
- Male
Acute coronary syndrome
medicine.medical_specialty
Contrast Media
Case Report
Gadolinium
030204 cardiovascular system & hematology
Left ventricular hypertrophy
Chest pain
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
AL amyloidosis
Humans
030212 general & internal medicine
Acute Coronary Syndrome
Heart Failure
business.industry
Amyloidosis
General Medicine
Middle Aged
medicine.disease
Blood pressure
Cardiac amyloidosis
Heart failure
Cardiology
medicine.symptom
business
- Language
- English
A 53-year-old man presented to a district general hospital with chest pain, ECG changes and a small high-sensitivity cardiac troponin I rise. There were no symptoms of heart failure. CT coronary angiography revealed moderate calcific disease and conventional angiography confirmed no flow limitation. Echocardiography showed left ventricular hypertrophy (LVH). His blood pressure remained normal throughout his admission. The tertiary centre labelled this as a ‘plaque rupture’ event but the LVH remained unexplained. Cardiac MRI displayed an unusual pattern of late gadolinium enhancement, which was not classical of amyloid. However, a raised serum free kappa light chain along with the deposition of amyloid on his bone marrow aspirate confirmed the diagnosis of primary AL amyloidosis with cardiac involvement. The patient went on to have chemotherapy and remained stable at 1-year follow-up.