Work

Case report: recurrent chest pain as initial manifestation of rapidly progressing light-chain cardiac amyloidosis with microvascular infiltration—a novel red flag associated with poor outcomes

Year: 2025

Type: article

Abstract: Background: Angina due to microvascular amyloid infiltration is an under-recognized early red flag of infiltrative disease and should be investigated as a predictor of poor outcomes. Case summary: A 73-year-old man with cardiovascular risk factors and a history of treated obstructive coronary artery disease presented 10 months later with recurrent angina. His condition progressively worsened, with the development of severe dyspnoea. Within 6 months, he succumbed to cardiogenic shock in the presence of severe biventricular dysfunction and unobstructed coronary arteries. Post-mortem diagnosis revealed AL cardiac amyloidosis with massive myocardial infiltration and extensive microvascular amyloid deposits. Discussion: This case underscores chest pain as a critical clinical marker, potentially indicating microvascular amyloid infiltration in patients with light-chain cardiac amyloidosis, particularly those with unobstructed coronary arteries. Its assessment may also have implications for future therapies.

Source: European Heart Journal - Case Reports

DOI: 10.1093/ehjcr/ytaf521

Authors: Carla Indennidate, Aldostefano Porcari, Rossana Bussani, Marco Merlo, Gianfranco Sinagra

Institutions: University of Trieste, ERN GUARD-Heart, Azienda sanitaria universitaria Giuliano Isontina, The Royal Free Hospital, University College London

Language: English

Topic: Amyloidosis: Diagnosis, Treatment, Outcomes

Subfield: Molecular Biology

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $815