Primary systemic amyloidosis presenting as angina pectoris due to intramyocardial coronary artery involvement: a case report

We describe a 76-year-old Japanese woman with primary systemic amyloidosis who presented with angina pectoris associated with ST-segment and T-wave abnormalities resulting from intramyocardial coronary artery amyloidosis. The patient was admitted to our hospital because of dyspnea and pretibial edem...

Full description

Saved in:
Bibliographic Details
Published in:Heart and vessels 2002-05, Vol.16 (4), p.157-160
Main Authors: Yamano, Shigeru, Motomiya, Kotomi, Akai, Yasuhiro, Shiiki, Hideo, Toyama, Takayuki, Hashimoto, Toshio, Fujimoto, Shinichi, Nakamura, Shinobu, Fukuoka, Yoshiaki
Format: Article
Language:English
Subjects:
Aged
Amyloidosis - complications
Amyloidosis - diagnosis
Angina pectoris
Angina Pectoris - diagnosis
Angina Pectoris - etiology
Arteries - pathology
Autopsy
Cardiomyopathies - complications
Cardiomyopathies - diagnosis
Case studies
Coronary Artery Disease - complications
Coronary Artery Disease - diagnosis
Coronary vessels
Coronary Vessels - pathology
Diagnosis, Differential
Electrocardiography
Female
Humans
Myocardium - pathology
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We describe a 76-year-old Japanese woman with primary systemic amyloidosis who presented with angina pectoris associated with ST-segment and T-wave abnormalities resulting from intramyocardial coronary artery amyloidosis. The patient was admitted to our hospital because of dyspnea and pretibial edema 7 years after the diagnosis of variant angina. A diagnosis of primary systemic amyloidosis (AL amyloid protein) was made after examination of gastric and endomyocardial biopsy specimens. The patient died of progressive, uncontrolled heart failure 3 months later. An autopsy study demonstrated only mild-to-moderate atherosclerosis in the epicardial coronary arteries. However, histological examination of the heart revealed diffuse stenoses and obstructions in the intramural coronary arteries by amyloid deposits. This patient had small-vessel coronary disease with ST-segment changes and angina caused by cardiac amyloidosis. A correct diagnosis of ischemic heart disease due to primary amyloidosis is important for estimation of the prognosis and for appropriate management.
ISSN:0910-8327
1615-2573
DOI:10.1007/s003800200013