Isolated atrial amyloidosis was incidentally diagnosed via routine postoperative pathology in a 74-year-old woman with diastolic heart failure and refractory atrial fibrillation.
Case Report (n=1)
No
Isolated atrial amyloidosis may contribute to significant morbidity including refractory AF and diastolic heart failure, warranting further study and standardized diagnostic approaches.
A 74-year-old woman with a history of diastolic heart failure and refractory atrial fibrillation (AF) presented with unstable angina for coronary artery bypass grafting. Routine pathological analysis of tissue specimens obtained from the left atrial appendage revealed subendocardial and interstitial fibrosis and patchy amyloid deposits with Congo red staining demonstrating filamentous deposits. Mass spectrometry was consistent with isolated atrial amyloidosis (IAA). IAA in this patient was found incidentally on routine postoperative pathology, but likely contributed to significant morbidity. The established relationship between IAA with AF and diastolic heart failure underscores the relevance. Further delineating the pathogenesis has potentially immense implications for the future management of associated conditions. To bridge the gaps in the understanding, a standardised approach to diagnosis is needed to open the door to a large-scale study and further work toward establishing evidence-based management pathways.
Hyer et al. (Tue,) conducted a case report in Isolated atrial amyloidosis (n=1). Isolated atrial amyloidosis was incidentally diagnosed via routine postoperative pathology in a 74-year-old woman with diastolic heart failure and refractory atrial fibrillation.
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