Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm
Cardiac amyloidosis is a condition when amyloid fibers are deposited in the extracellular space of the heart causing tachyarrhythmias, heart failure, or sudden cardiac death. We present a 71-year-old woman presenting with dyspnea on admission. Echocardiogram revealed diastolic heart failure and left...
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2021-01-01
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doaj-5d80582f862442acaaf7798700bd8eab2021-07-05T00:02:54ZengHindawi LimitedCase Reports in Medicine1687-96352021-01-01202110.1155/2021/3293728Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical StormAdithya T. Mathews0Abu-Sayeef Mirza1Chandrashekar Bohra2Akshay G. Mathews3Philip Ritucci-Chinni4Jamie L. Weber5William W. Bulkeley6Maqsood Siddique7David Whitaker8Richard Bowerman9Department of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineUniversity of South FloridaDepartment of Internal MedicineDepartment of Internal MedicineDepartment of PathologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyCardiac amyloidosis is a condition when amyloid fibers are deposited in the extracellular space of the heart causing tachyarrhythmias, heart failure, or sudden cardiac death. We present a 71-year-old woman presenting with dyspnea on admission. Echocardiogram revealed diastolic heart failure and left ventricular hypertrophy with strain pattern concerning for an infiltrative process. She was discharged with diuretic therapy and scheduled for a cardiac magnetic resonance imaging. One week after discharge, she was readmitted with progressive shortness of breath and syncope. She was found to be in shock and had multiple episodes of cardiac arrest with both ventricular tachycardia and pulseless electrical activity. She developed electrical storm and eventually passed within 24 hours. Autopsy revealed gross cardiomegaly and left ventricular hypertrophy with Congo red staining revealing amyloid fibrils with apple-green birefringence. This case demonstrates the rapid progression of cardiac amyloidosis from acute-onset diastolic heart failure to uncontrollable ventricular tachycardia, and eventually death. We review the literature regarding multiple diagnostic modalities that facilitate the confirmation of cardiac amyloidosis.http://dx.doi.org/10.1155/2021/3293728 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adithya T. Mathews Abu-Sayeef Mirza Chandrashekar Bohra Akshay G. Mathews Philip Ritucci-Chinni Jamie L. Weber William W. Bulkeley Maqsood Siddique David Whitaker Richard Bowerman |
spellingShingle |
Adithya T. Mathews Abu-Sayeef Mirza Chandrashekar Bohra Akshay G. Mathews Philip Ritucci-Chinni Jamie L. Weber William W. Bulkeley Maqsood Siddique David Whitaker Richard Bowerman Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm Case Reports in Medicine |
author_facet |
Adithya T. Mathews Abu-Sayeef Mirza Chandrashekar Bohra Akshay G. Mathews Philip Ritucci-Chinni Jamie L. Weber William W. Bulkeley Maqsood Siddique David Whitaker Richard Bowerman |
author_sort |
Adithya T. Mathews |
title |
Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm |
title_short |
Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm |
title_full |
Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm |
title_fullStr |
Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm |
title_full_unstemmed |
Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm |
title_sort |
diagnosing cardiac amyloidosis: from heart failure to electrical storm |
publisher |
Hindawi Limited |
series |
Case Reports in Medicine |
issn |
1687-9635 |
publishDate |
2021-01-01 |
description |
Cardiac amyloidosis is a condition when amyloid fibers are deposited in the extracellular space of the heart causing tachyarrhythmias, heart failure, or sudden cardiac death. We present a 71-year-old woman presenting with dyspnea on admission. Echocardiogram revealed diastolic heart failure and left ventricular hypertrophy with strain pattern concerning for an infiltrative process. She was discharged with diuretic therapy and scheduled for a cardiac magnetic resonance imaging. One week after discharge, she was readmitted with progressive shortness of breath and syncope. She was found to be in shock and had multiple episodes of cardiac arrest with both ventricular tachycardia and pulseless electrical activity. She developed electrical storm and eventually passed within 24 hours. Autopsy revealed gross cardiomegaly and left ventricular hypertrophy with Congo red staining revealing amyloid fibrils with apple-green birefringence. This case demonstrates the rapid progression of cardiac amyloidosis from acute-onset diastolic heart failure to uncontrollable ventricular tachycardia, and eventually death. We review the literature regarding multiple diagnostic modalities that facilitate the confirmation of cardiac amyloidosis. |
url |
http://dx.doi.org/10.1155/2021/3293728 |
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