Abstract
The most frequent presentation of cardiac amyloidosis is with endomyocardial deposition, and resultant restrictive cardiomyopathy. We present a case of primary systemic amyloidosis causing constrictive pericarditis (CP) and congestive heart failure without clinical evidence of endomyocardial deposition. A comprehensive evaluation by noninvasive and invasive studies facilitated the differentiation of CP from restrictive cardiomyopathy and the patient was effectively treated with pericardectomy. To our knowledge, this is the first documented case of primary systemic amyloidosis causing selective CP with successful antemortem diagnosis and treatment in a young man.
References
1.
Smith TJ, Kyle RA, Lie JT: Clinical significance of histopathologic patterns of cardiac amyloidosis. Mayo Clin Proc 1984;59:547–555.
2.
Daubert JP, Gaede J, Cohen HJ: A fatal case of constrictive pericarditis due to a marked, selective pericardial accumulation of amyloid. Am J Med 1993;94:335–340.
3.
Selvanayagam JB, Hawkins PN, Paul B, Myerson SG, Neubauer S: Evaluation and management of the cardiac amyloidosis. J Am Coll Cardiol 2007;50:2101–2110.
4.
Meaney E, Shabetai R, Bhargava V, et al: Cardiac amyloidosis, contrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol 1976;38:547–556.
5.
Chinnaiyan KM, Leff CB, Marsalese DL: Constrictive pericarditis versus restrictive cardiomyopathy: challenges in diagnosis and management. Cardiol Rev 2004;12:314–320.
6.
Kern MJ, Lorell BH, Grossman W: Cardiac amyloidosis masquerading as constrictive pericarditis. Cathet Cardiovasc Diagn 1982;8:629–635.
7.
Dubrey SW, Cha K, Anderson J, et al: The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement. QJM 1998;91:141–157.
8.
Asher CR, Klein AL: Diastolic heart failure: restrictive cardiomyopathy, constrictive pericarditis, and cardiac tamponade: clinical and echocardiographic evaluation. Cardiol Rev 2002;10:218–229.
9.
Desai HV, Aronow WS, Peterson SJ, Frishman WH: Cardiac amyloidosis: approaches to diagnosis and management. Cardiol Rev 2010;18:1–11.
10.
Meijers BK, Schalla S, Eerens F, et al: Protein-losing enteropathy in association with constrictive pericarditis. Int J Cardiovasc Imaging 2006;22:389–392.
© 2011 S. Karger AG, Basel
2011
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