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Table of Contents
A PICTURE IS WORTH A THOUSAND WORDS
Year : 2021  |  Volume : 22  |  Issue : 3  |  Page : 231-232  

Cardiac amyloidosis


Department of Cardiology, Heart Hospital, Doha, Qatar

Date of Submission31-Aug-2021
Date of Acceptance01-Sep-2021
Date of Web Publication11-Oct-2021

Correspondence Address:
Dr. Salah Elbdri
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, P. O. Box 3050, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/heartviews.heartviews_94_21

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How to cite this article:
Elbdri S, Hajar R. Cardiac amyloidosis. Heart Views 2021;22:231-2

How to cite this URL:
Elbdri S, Hajar R. Cardiac amyloidosis. Heart Views [serial online] 2021 [cited 2021 Dec 1];22:231-2. Available from: https://www.heartviews.org/text.asp?2021/22/3/231/328028



Amyloidosis is due to the deposition of amyloid fibrils in various organs. If it affects the heart, it is known as "stiff heart syndrome." The predominant morphologic feature in the heart is an increase in myocardial wall thickness (>15 mm) without dilatation of the left ventricular (LV) cavity. This can usually be seen on echocardiography and is the hallmark of cardiac amyloidosis [Figure 1].
Figure 1: Transthoracic echocardiogram showing left ventricular hypertrophy

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Amyloid deposits in the heart are diffuse and may involve the valves, myocardium, interatrial septum, and pericardium. Other conditions may produce similar echocardiographic features. Patients with cardiac amyloidosis usually have a low QRS voltage [Figure 2] or a pseudoinfact pattern on electrocardiogram (ECG). Pulse-wave Doppler inflow through the mitral shows severe diastolic dysfunction or restriction [Figure 3].
Figure 2: Electrocardiogram showing low QRS voltage

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Figure 3: Pulsed Doppler inflow through mitral valve shows severe (Grade 3–4) diastolic restriction (increased E, decreased A)

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The above images belong to a female patient who was 80 years old and admitted with decompensated heart failure for which she was being treated for the last 2 years. She also was being treated for hypertension and dyslipidemia. She had numbness of fingers and symptoms similar to those of carpal tunnel syndrome. Her ECG showed low QRS voltage and her echo showed concentric LV hypertrophy with the restrictive pattern on pulsed-wave Doppler tracing of the mitral valve. These are enough data to provide comprehensive morphologic, functional, and prognostic information. She also had carpal tunnel syndrome, and amyloidosis is known to be associated with it, because of amyloid deposition in the tendon.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.




    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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