What is the clinical evidence from this study?

Study design: Case Report. Population: Cardiac amyloidosis (n=1). Intervention: Diagnostic evaluation and symptom management (Furosemide). Primary outcome: Clinical condition and symptom severity.

October 21, 2024International Journal of Emergency Medicine0 citationsOpen Access

Diagnostic and therapeutic challenges in rapidly progressing cardiac amyloidosis: a literature review based on case report

NSNahid SenobariShahid Beheshti University of Medical Sciences RNRoozbeh NazariShahid Beheshti University of Medical Sciences PEPouya EbrahimiInterventional / Structural Cardiology

Key Result

In a 56-year-old female with rapidly progressing cardiac amyloidosis, early diagnosis using cardiac magnetic resonance imaging and treatment with furosemide led to improved clinical condition and reduced dyspnea.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 56-year-old female with rapidly progressing cardiac amyloidosis who presented with dyspnea and palpitations.

Intervention

Furosemide 40 mg twice per day

Outcome

Clinical condition improvement (subjective dyspnea, blood oxygen saturation, and lung crackles)

Early suspicion and multimodality imaging, particularly CMRI, are crucial for the timely diagnosis and management of rapidly progressing cardiac amyloidosis.

Limitations

Single case report limits generalizability
Patient refused recommended biventricular pacemaker insertion and cardiac catheterization

Abstract

INTRODUCTION: Cardiac amyloidosis is a rarely reported and potentially fatal variant of the systemic disease. Its early diagnosis could potentially lead to significantly improved clinical outcomes. CASE PRESENTATION: A 56-year-old female presented with dyspnea and palpitations. Her physical exam and non-invasive evaluation with cardiac magnetic resonance imaging (CMRI) revealed restrictive cardiomyopathy, and the bone marrow biopsy results showed systemic amyloidosis. DISCUSSION: The diagnosis of cardiac amyloidosis is not always straightforward, and delay can cause the progression of the disease and an increased risk of morbidity and mortality. Electrocardiograms, echocardiograms, cardiac magnetic resonance imaging, and histopathologic evaluation are the main methods for diagnosing cardiac amyloidosis. The treatment consists of controlling heart failure symptoms and disease-modifying interventions, including medical and surgical therapeutic methods. CLINICAL LEARNING POINT (CONCLUSION): Cardiac involvement is the main cause of death in systemic amyloidosis. Early suspicion, diagnosis, and treatment are crucial in improving patients' survival. CMRI can play an essential role in the diagnosis of cardiac Amyloidosis. A graphical abstract is provided for visual summary.

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