Key result
Atrial mechanical dysfunction in familial ATTR amyloidosis linked to embolic stroke without documented AF.
Why the study?
Atrial mechanical dysfunction from protein deposition in cardiac amyloidosis may cause intracardiac thrombus formation even without atrial arrhythmia, highlighting the need to understand stroke risk in this population.
Case Report (n=1)
This case highlights that atrial mechanical dysfunction in cardiac amyloidosis can lead to thrombus formation and embolic stroke even in the absence of atrial fibrillation.
Atrial dysfunction may confer thromboembolism risk in cardiac amyloidosis without AF; single case leaves screening and anticoagulation questions open.
Amyloidosis is associated with poor prognosis, and patients with cardiac involvement have especially poor outcomes. Cardiac amyloidosis leads to higher rates of atrial arrhythmia and an increased risk of intracardiac thrombus formation. However, atrial mechanical dysfunction due to protein deposition in amyloidosis may lead to thrombus formation in the absence of atrial arrhythmia. We present a 42-year-old male patient with familial transthyretin amyloidosis who suffered an embolic stroke that originated from a left atrial appendage thrombus in the absence of any documented atrial fibrillation. This case highlights atrial mechanical dysfunction in patients with cardiac amyloidosis and the need to better stratify thrombotic risk in this population with integration of echocardiographic parameters and transesophageal echocardiography.
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Ballantyne et al. (2020) conducted a case report in Familial transthyretin amyloidosis (n=1). Atrial mechanical dysfunction in a 42-year-old male with familial transthyretin amyloidosis led to an embolic stroke from a left atrial appendage thrombus without documented atrial fibrillation.
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