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http://dx.doi.org/10.4070/kcj.2011.41.4.209

A Case of a Senile Systemic Amyloidosis Patient Presenting With Angina Pectoris and Dilated Cardiomyopathy  

Kang, Gu-Hyun (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Ryu, Dong-Ryeol (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Song, Pil-Sang (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Song, Young-Bin (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Hahn, Joo-Yong (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Seung-Hyuck (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Gwon, Hyeon-Cheol (Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Korean Circulation Journal / v.41, no.4, 2011 , pp. 209-212 More about this Journal
Abstract
A 77-year-old man visited our hospital complaining of aggravated exertional chest pain. He was diagnosed with syndrome X 7 years ago and underwent medical treatment in a regional hospital. Coronary angiography and echocardiography did not show any significant abnormalities. On the seventh in-hospital day, cardiogenic shock developed and echocardiography showed a dilated left ventricular (LV) cavity and severe LV systolic dysfunction. We thus inserted an intra-aortic balloon pump for hemodynamic support and were forced to maintain it because of weaning failure several times. Finally, heart transplantation was the decided necessary procedure. After successful heart transplantation, the biopsy specimen revealed a wild-type transthyretin deposition indicating senile systemic amyloidosis in the intramuscular coronary vessels and interstitium. Cardiac biopsy at the 4-year follow-up showed no recurrence of amyloid deposition.
Keywords
Amyloidosis; Heart transplantation; Microvascular angina;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Cornwell GG 3rd, Westermark P. Senile amyloidosis: a protean manifestation of the aging process. J Clin Pathol 1980;33:1146-52.   DOI
2 Al Suwaidi J, Velianou JL, Gertz MA, et al. Systemic amyloidosis presenting with angina pectoris. Ann Intern Med 1999;131:838-41.
3 Whitaker DC, Tungekar MF, Dussek JE. Angina with a normal coronary angiogram caused by amyloidosis. Heart 2004;90:e54.   DOI   ScienceOn
4 Mueller PS, Edwards WD, Gertz MA. Symptomatic ischemic heart dise-ase resulting from obstructive intramural coronary amyloidosis. Am J Med 2000;109:181-8.   DOI   ScienceOn
5 Yamano S, Motomiya K, Akai Y, et al. Primary systemic amyloidosis presenting as angina pectoris due to intramyocardial coronary artery involvement: a case report. Heart Vessels 2002;16:157-60.   DOI   ScienceOn
6 Zabernigg A, Schranzhofer R, Kreczy A, Gattringer K. Continuously elevated cardiac troponin I in two patients with multiple myeloma and fatal cardiac amyloidosis. Ann Oncol 2003;14:1791.   DOI   ScienceOn
7 Cantwell RV, Aviles RJ, Bjornsson J, et al. Cardiac amyloidosis presenting with elevations of cardiac troponin I and angina pectoris. Clin Cardiol 2002;25:33-7.
8 Kaski JC, Elliott PM. Angina pectoris and normal coronary arteriograms: clinical presentation and hemodynamic characteristics. Am J Cardiol 1995;76:35D-42D.   DOI   ScienceOn
9 Ogawa H, Mizuno Y, Ohkawara S, et al. Cardiac amyloidosis presenting as microvascular angina: a case report. Angiology 2001;52:273-8.   DOI   ScienceOn
10 Mesquita T, Chorao M, Soares I, Mello e Silva A, Abecasis P. Primary amyloidosis as a cause of microvascular angina and intermittent claudication. Rev Port Cardiol 2005;24:1521-31.
11 Ikeda S. Unusual clinical manifestations of primary systemic AL amy-loidosis: are myasthenic symptoms and dilated cardiomyopathy caus-ed by muscular or myocardial amyloid angiopathy? Intern Med 2006; 45:123-4.   DOI   ScienceOn
12 Yoshita M, Ishida C, Yanase D, Yamada M. Immunoglobulin light-ch-ain (AL) amyloidosis with myasthenic symptoms and echocardiographic features of dilated cardiomyopathy. Intern Med 2006;45:159-62.   DOI   ScienceOn
13 Tsuda T, Izumi T, Shibata A. Clinical assessment of serum myosin light chain I in patients with dilated cardiomyopathy. Kaku Igaku 1992; 29:1035-9.
14 Siqueira-Filho AG, Cunha CL, Tajik AJ, Seward JB, Schattenberg TT, Giuliani ER. M-mode and two-dimensional echocardiographic features in cardiac amyloidosis. Circulation 1981;63:188-96.   DOI   ScienceOn
15 Chae JK. A case of secondary amyloidosis involving heart. Korean Circ J 2000;30:1179-83.   DOI
16 Oh SS, Youn HJ, Park JH, et al. Endomyocardial biopsy: one center's report about its role. Korean Circ J 2008;38:374-8.   DOI   ScienceOn
17 Fuchs U, Zittermann A, Suhr O, et al. Heart transplantation in a 68- year-old patient with senile systemic amyloidosis. Am J Transplant 2005;5:1159-62.   DOI   ScienceOn
18 Dubrey SW, Burke MM, Hawkins PN, Banner NR. Cardiac transpl-antation for amyloid heart disease: the United Kingdom experience. J Heart Lung Transplant 2004;23:1142-53.   DOI   ScienceOn
19 Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation 2005;112:2047-60.   DOI   ScienceOn
20 McCarthy RE 3rd, Kasper EK. A review of the amyloidoses that infiltrate the heart. Clin Cardiol 1998;21:547-52.   DOI   ScienceOn