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Hjärtamyloidos - tänkbar genes vid oklar diastolisk hjärtsvikt. Hypertroft myokardium och låga-normala QRS-komplex är karakteristiskt
Engelsk titel: Cardiac amyloidosis - possible etiology in unclear diastolic heart failure. Hypertrophic myocardium and low-normal QRS-amplitude is characteristic Läs online Författare: Labaf, Ashkan ; Tasevska, Gordana ; Ahlgren, Tomas ; Stagmo, Martin Språk: Swe Antal referenser: 30 Dokumenttyp: Fallbeskrivning UI-nummer: 15047002

Tidskrift

Läkartidningen 2015;112(10)468-71 ISSN 0023-7205 E-ISSN 1652-7518 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

Sammanfattning

Amyloidosis refers to a rare group of disorders, which can involve various organs. It is caused by extracellular deposition of insoluble abnormal fibrils called amyloid. Cardiac amyloidosis in patients with AL-amyloidosis is common and associated with poor prognosis. Characteristic symptoms are low voltage ECG, echocardiographic findings of hypertrophy, diastolic dysfunction and symptoms of right heart failure. We present a 51 year-old patient with dyspnea and chest pain and recurring pleura effusions. ECG showed T-wave inversions in the lateral and inferior leads with normal QRS-amplitude and first echocardiography showed moderate concentric hypertrophy left ventricle, moderate enlarged atria and a restrictive diastolic filling pattern. The coronary angiography was normal. The diagnosis was delayed for several months and the symptoms worsened. Physicians must be aware of amyloidosis and other infiltrative cardiomyopathies as differential diagnosis in patients with unclear diastolic dysfunction even with normal QRS-amplitude.