Cardiac Amyloidosis Presenting as Microvascular Angina

Angiology - Tập 52 Số 4 - Trang 273-278 - 2001
Hisao Ogawa1, Yuji Mizuno2, Susumu Ohkawara3, Kenichi Tsujita2, Yukio Ando4,5, Masaru Yoshinaga3, Hirofumi Yasue2
1Departments of Pathology, and Laboratory Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.Departments of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
2Departments of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
3Departments of Pathology Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
4Departments of Laboratory Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
5Faculty of Life Science (Medical Sciences/Clinical research), Center for Sensorimotor & Neural Sciences in the Unprecedented Aging Society

Tóm tắt

Cardiac amyloidosis usually presents with heart failure, but rarely leads to coronary insuffi ciency. The authors report a case of a 69-year-old Japanese woman with cardiac amyloidosis presenting as microvascular angina. She had exertional angina with positive exercise test and normal coronary angiograms. However, heart failure developed, and she died 3 years after symptom onset. On autopsy, coronary arteries were patent. In contrast to that of the epicar dial coronary arteries, histologic examination of the heart revealed severe obstructive alter ations of the intramural coronary arteries with amyloid. Furthermore, amyloid was present mainly in the endocardium and the intramural coronary arteries, but there was little present in the myocardium. This case was a rare AL amyloidosis. There have been only 4 reported cases of cardiac amyloidosis that presented with exertional angina, a positive exercise test, and normal coronary angiograms and histologic examination.

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Angiology

Tập 52 Số 4

273-278

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