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International Archives of
Cardiovascular Diseases ISSN: 2643-3966

Citation

Brock M, Sanchorawala V, Berk JL, Cui H, Gopal DM, et al. (2019) Left Ventricular Hypertrophy in a Patient with AL Amyloidosis: A Rare Overlap of Two Cardiomyopathies. Int Arch Cardiovasc Dis 3:020. doi.org/10.23937/2643-3966/1710020

Copyright

© 2019 Brock M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/2643-3966/1710020

Left Ventricular Hypertrophy in a Patient with AL Amyloidosis: A Rare Overlap of Two Cardiomyopathies

Brock M1, Sanchorawala V2,3, Berk JL3, Cui H3,4, Gopal DM3,5, O'Hara C3,4, Ruberg FL3,5,6 and Siddiqi OK3,5*

1Department of Internal Medicine, Boston Medical Center, USA

2Division of Hematology and Oncology, Boston University School of Medicine, Boston Medical Center, USA

3Amyloidosis Center, Boston University School of Medicine, USA

4Department of Pathology, Boston University School of Medicine, Boston Medical Center, USA

5Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, USA

6Department of Radiology, Boston University School of Medicine, Boston Medical Center, USA

Abstract

A 62-year-old woman with newly diagnosed systemic AL amyloidosis was evaluated for severely increased left ventricular (LV) wall thickness. Her echocardiographic, cardiac MRI, and genetic findings led to a diagnosis of hypertrophic cardiomyopathy (HCM). Five years after achieving relative a partial hematologic response with chemotherapy, the patient died after developing rapidly progressive heart failure and cardiogenic shock. A full autopsy diagnosed both cardiac amyloidosis and HCM. The overlapping phenotypes of these two diseases resulted in a clinical diagnostic dilemma. This case highlights the importance of tissue diagnosis and genetic analysis in the evaluation of LV wall thickening when conflicting clinical features suggest divergent diagnoses.