Cardiac Amyloidosis: A Diagnostic Dilemma and the Role of a Novel Electrocardiogram Criterion.

Authors

Muhammad Asad Hanif, Department of Internal Medicine, Tower Health, Reading Hospital, West Reading, USAFollow
Tuoyo O Mene-Afejuku, Department of Cardiology Tower Health System, Reading Hospital, West Reading, Pennsylvania, USA.Follow
Olivera Chandler, Department of Cardiology, Tower Health, Reading Hospital, West Reading, USAFollow
Julian Diaz Fraga, Department of Cardiology, Tower Health, Reading Hospital, West Reading, USAFollow

Document Type

Article

Publication Date

7-1-2022

Abstract

Cardiac amyloidosis is an infiltrative disease of the myocardium. Nearly all cases of clinical cardiac amyloidosis are caused by transthyretin amyloidosis or light chain amyloidosis. Clinical manifestations are consistent with those of refractory heart failure secondary to irreversible restrictive cardiomyopathy, autonomic abnormalities as well as neuropathy. Delay in diagnosis is a challenge, as symptoms and signs of cardiac amyloidosis are nonspecific. One of the hallmarks of cardiac amyloidosis is the discordance between the increased left ventricular wall thickness and low QRS voltages on the electrocardiogram. Diagnostic delay may lead to deleterious consequences as prompt therapy, if feasible, would be hampered. We, therefore, present a case of cardiac amyloidosis presenting with syncope and refractory heart failure to highlight the diagnostic dilemma as well as to stress upon the utility of a novel electrocardiogram criterion that may assist in the diagnosis of cardiac amyloidosis.

Publication Title

Cureus

Volume

14

Issue

7

First Page

26561

Last Page

26561

Recommended Citation

Hanif, M., Mene-Afejuku, T., Chandler, O., & Diaz Fraga, J. (2022). Cardiac Amyloidosis: A Diagnostic Dilemma and the Role of a Novel Electrocardiogram Criterion.. Cureus, 14 (7), 26561-26561. https://doi.org/https://doi.org/10.7759%2Fcureus.26561