Cardiac amyloidosis: a case series review

Abstract

Background: Cardiac amyloidosis is an entity that remains underdiagnosed, despite recent advances in its diagnosis and treatment. Objective: The aim of this study is to review a series of cardiac amyloidosis cases to describe the main clinical data and the findings in the imaging tests. Materials and methods: Retrospective study of patients with primary or secondary diagnosis of cardiac amyloidosis in discharge reports of patients hospitalized in our center from 2006 to 2016. The clinical data of the patients were reviewed, as well as the imaging tests (Electrocardiogram [ECG], echocardiogram, cardiac scintigraphy, and cardiac magnetic resonance). Patients were followed until January 2018. Results: We analyze 30 patients (20 men) with an average of 65 years. The main echocardiographic data were biatrial dilatation, diastolic dysfunction, and left ventricular hypertrophy (LVH) in 97%. Only 6.7% met criteria for LVH in the ECG. Up to 33% had systolic dysfunction. Scintigraphy and cardiac magnetic resonance were performed in 33%. Survival at 12 months was 61%. Conclusion: The presence of heart failure, atrial fibrillation, or conduction disorders with suggestive echocardiographic data should alert the clinician. Other data such as systolic dysfunction or female sex should not decrease the suspicion. The study should be completed with gammagraphy and cardiac magnetic resonance since early diagnosis has prognostic and therapeutic implications .