Systemic Amyloidosis Involves Heart A Case Report And Literature Review

Objective:To investigate the clinical characteristics,diagnosis and prognosis of systemic amyloidosis involving heart.Methods: A patient with systemic amyloidosis involving heart was analyzed,and a literature review was conducted.Cases: Patients are hospitalized for repeated heart failure,repeated syncope,accompanied by liver and kidney dysfunction.Echocardiogram shows double atrial enlargement and decreased ventricular septal movement,slightly thickened left ventricular posterior wall.Left ventricular diastolic function was significantly reduced,and left ventricular systolic function was slightly reduced.Electrocardiograph(ECG)presented low voltage,arrhythmia.Intervention and results: The heart failure was treated with diuretics intermittently,combined with Improving renal function and correcting anemia therapies.Then,the patient’s chest tightness and shortness of breath improved.Conclusion: Systemic amyloidosis is a group of heterogeneous diseases that can involve multiple systems.The following characteristics may occur when the heart is involved: echocardiography shows decreased left ventricular diastolic dysfunction,thickened ventricular wall accompanied with frit-like change,ECG shows standard limb lead low voltage,chest lead R wave,symptoms and signs of restrictive cardiomyopathy,orthostatic hypotension,syncope,a variety of arrhythmias.Every organization and organ can be involved by systemic amyloidosis,clinical manifestations were complex,diverse,and non-specific,which will be misdiagnosed.The gold standard for diagnosis of myocardial amyloidosis is endocardial myocardial biopsy.Systemic amyloidosis has poor prognosis.When the heart was involved and presented heart failure,the prognosis is worse.Median survival is often less than 6 months.The general principle of treatment is the etiological treatment and symptomatic treatment,the former includes chemotherapy and transplantation.