Microvascular cardiac amyloidosis should be considered in the differential diagnosis for patients presenting with severe intractable angina and normal coronary angiograms.
Microvascular cardiac amyloidosis may explain refractory angina with normal coronaries; this case leaves open any causal role for sympathectomy.
A case of severe intractable angina pectoris with normal angiography is presented. Following video assisted thoracic sympathectomy the patient died of heart failure. Microvascular cardiac amyloidosis was diagnosed at the postmortem examination. This report alerts clinicians to this possible diagnosis when treating patients with severe angina when no cause is found and discusses the poor prognosis in such cases.
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D C Whitaker (2004) studied this question.
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