Key result
Occult intramural coronary amyloidosis causes severe luminal compromise, triggering fatal cardiac ischemia without myocardial involvement.
Why the study?
Occult cardiac amyloidosis can cause severe cardiac ischemia and sudden death but is difficult to diagnose when other cardiac conditions exist.
Case Report (n=1)
Consider occult coronary-predominant amyloid in unexplained rapid cardiac decline; leaves open its frequency and antemortem detection.
A 68-year-old man with known coronary heart disease experienced rapidly progressive cardiac dysfunction and was found to have occult cardiac amyloidosis at autopsy. The amyloidosis was undiagnosed during life and initially at autopsy. Marked diffuse involvement of the intramural coronary arteries by amyloid deposits resulted in severe luminal compromise of numerous medium and small vessels. The myocardium proper was virtually spared from amyloid deposits. Amyloid-related coronary narrowing contributed to cardiac ischemia and sudden death. The significance of amyloid coronary disease in this patient relates primarily to the difficulty in considering the diagnosis when other reasons for cardiac signs and symptoms preexist. Also, the adverse effects of amyloid coronary disease may be profound without direct myocardial involvement.
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Petersen et al. (1992) conducted a case report in Occult cardiac amyloidosis (n=1). Amyloid-related coronary disease was evaluated on Autopsy findings of cardiac amyloidosis and cause of death. Occult cardiac amyloidosis involving intramural coronary arteries without direct myocardial involvement caused severe luminal compromise, contributing to cardiac ischemia and sudden death.
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