Advertisement

Light-chain cardiac amyloidosis: A multimodality approach

  • Erick Alexanderson-Rosas
  • Mara Escudero-Salamanca
  • Jesus A. Garcia-Diaz
  • Ricardo Alvarez-Santana
  • Roberto Cano-Zarate
  • Julio Mamani-Tito
  • Isabel Carvajal-Juarez
  • Nilda Espinola-ZavaletaEmail author
Images that Teach
  • 19 Downloads

Introduction

Amyloidosis is a multisystemic disease, caused by deposits of misfolded protein fragments. There are two main types of amyloidosis, the light-chain (AL) and transthyretin-related amyloidosis, both of them, affect the heart. Cardiac affection usually manifests with heart failure. The non-invasive diagnostic methods used to establish the diagnosis are echocardiography, cardiac magnetic resonance (CMR) and pyrophosphate scintigraphy.1-3 Endomyocardial biopsy is the gold standard for diagnosis of cardiac amyloidosis, however, CMR, single-photon emission computed tomography using specific amyloid radiotracers have been shown to have high sensitivity and specificity.2,3

Case Presentation

A 59-year-old male came to the emergency room with dyspnea on exertion, orthopnea and precordial stabbing pain. On physical examination, a jugular plethora and holosystolic and meso-diastolic murmur were detected in the apex. Electrocardiogram in sinus rhythm, with flat T-waves, necrosis of...

Notes

Disclosures

Erick Alexanderson-Rosas, Mara Escudero-Salamanca, Jesus A Garcia-Diaz, Ricardo Alvarez-Santana, Roberto Cano-Zarate, Julio Mamani-Tito, Isabel Carvajal-Juarez, Nilda Espinola-Zavaleta have no disclosure to declare.

References

  1. 1.
    Van Dalen BM, Soliman OI, Vletter WB, ten Cate FJ, Geleijnse ML. Insight into left ventricular function from the time course of regional and global rotation by speckle tracking echocardiography. Echocardiography 2009;26:371-7.CrossRefGoogle Scholar
  2. 2.
    Bokhari S, Castaño A, Pozniakoff T, Deslisle S, Latif F, Maurer MS. 99m Tc-Pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses. Circ Cardiovasc Imaging 2013;6:195-201.CrossRefGoogle Scholar
  3. 3.
    Fontana M, Pica S, Reant P, Abdel-Gadir A, Treibel TA, Banypersad SM, et al. Prognostic value of late gadolinium enhancement cardiovascular magnetic resonance in cardiac amyloidosis. Circulation 2015;132:1570-9.CrossRefGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2020

Authors and Affiliations

  • Erick Alexanderson-Rosas
    • 1
    • 2
  • Mara Escudero-Salamanca
    • 1
    • 3
  • Jesus A. Garcia-Diaz
    • 1
    • 4
  • Ricardo Alvarez-Santana
    • 1
    • 5
  • Roberto Cano-Zarate
    • 6
  • Julio Mamani-Tito
    • 1
  • Isabel Carvajal-Juarez
    • 1
  • Nilda Espinola-Zavaleta
    • 1
    • 7
    Email author
  1. 1.Nuclear Cardiology DepartmentNational Institute of Cardiology Ignacio ChavezMexico CityMexico
  2. 2.Physiology Department, Faculty of MedicineNational Autonomous University of MexicoMexico CityMexico
  3. 3.Mexican Faculty of MedicineLa Salle UniversityMexico CityMexico
  4. 4.Academic Unit of MedicineAutonomous University of NayaritTepic-NayaritMexico
  5. 5.Institute of Medical SciencesAutonomous University of Ciudad JuarezCiudad JuarezMexico
  6. 6.Magnetic Resonance DepartmentNational Institute of Cardiology Ignacio ChavezMexico CityMexico
  7. 7.Department of EchocardiographyABC Medical Center, I.A.PMexico CityMexico

Personalised recommendations