A systemic disease un...suspected by physical examination

A 73-year-old man was admitted to the cardiology department with unstable angina. He had a history of macroglossia with 3 years of development, attributed to hypothyroidism. On physical examination, he presented an exuberant macroglossia. The following diagnostic procedures were performed-ECG, in si...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2014-10, Vol.2014
Main Authors: Costa, Catia, Severino, Davide, Pitta, Maria Luz, Leal, Margarida
Format: Article
Language:English
Subjects:
Amyloidosis
Angina pectoris
Auscultation
Biopsy
Cardiac stress tests
Cardiology
Cardiovascular disease
Coronary vessels
Edema
Hypothyroidism
Medical imaging
Multiple myeloma
Systemic diseases
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 73-year-old man was admitted to the cardiology department with unstable angina. He had a history of macroglossia with 3 years of development, attributed to hypothyroidism. On physical examination, he presented an exuberant macroglossia. The following diagnostic procedures were performed-ECG, in sinus rhythm with low voltage criteria, and transthoracic echocardiography, which revealed a left ventricle with preserved function and marked wall thickening, with low strain values in basal segments. The coronary angiography confirmed a lesion of 90% in the right coronary artery, treated with two stents. Suspecting a systemic infiltrative disease, additional tests were performed and these revealed the presence of systemic amyloid light-chain (AL) amyloidosis with cardiac involvement, associated with multiple myeloma. The patient was sent to a consult of haematology to begin chemotherapy.
ISSN:1757-790X
DOI:10.1136/bcr-2014-205919