| Objective: By recording the clinical features and related examination results of patients with myocardial,studing the imaging features of ECG,echocardiography and MRI in the diagnosis,to strengthen the understanding of the disease,to further guide scientific research and provide reference for clinical work.Methods:Analyzed the clinical data,ECG,echocardiography and other results of 10 patients with Myocardial Amyloidosis,which diagnosed by subcutaneous fat biopsy,gingival tissue biopsy or renal biopsy,Reviewed the latest papers and research progresses to summarize the clinical features of myocardial amyloidosis.Results: In the study,Among the 10 patients,5 were female(50%)and 5 males(50%),The incidence rate for males and females is 1:1 and the age range is between 22 and 79.The average age is(55.40±16.11)years.Clinical manifestations: 10 cases of chest distress and fatigue(100%),6 cases of lower extremity edema(60%),chest pain in 6 cases(60%),dizziness in 4 cases(40%),cough and expectoration in 3 cases(30%),3 cases of proteinuria(30%),4 cases of pleural effusion(40%),1 case of diarrhea(10%).Eight patients showed low voltage in limb leads,2 cases of left anterior branch block,2 cases of complete right bundle branch block,5 cases of abnormal Q wave,4 cases of atrial premature beats,4 cases of premature ventricular contractions,and sinus bradycardia 1 case,6 cases of poor R wave progression in chest leads,10 cases of ST-T changes in some leads,3 cases of atrioventricular block,and 2 cases of atrial fibrillation.The ventricular septal thickness was increased in 9 patients(16.10±2.02)mm;the left ventricular end diastolic and left ventricular endsystolic were all normal;the left ventricular ejection fraction was reduced in 2 patients mean(58.00±11.21)%;The posterior wall of the left ventricle was thickened in 9 patients,with an average of(14.90±2.21)mm.The left atrium diameter was increased in 7 patients(average(39.00±7.85)mm).Thrombosis was found in 1 patient;the right ventricular diameter increased in 3 patients(averag 22.10±4.01)mm;left ventricular outflow tract was normal,1 case of right ventricular outflow tract was large,average(27.80 ± 5.49)mm;5 cases showed pulmonary hypertension,average(24.30 ± 5.90);8 patients had a small amount of pericardial effusion 7 patients had scattered bright echoes in the myocardium,and 6 patients showed different degrees of mitral regurgitation and tricuspid regurgitation.Among them,2 patients underwent cardiac MRI examination,both of which suggested that the left ventricular wall and interventricular septum were significantly thickened.NT-pro BNP increased in all patients to(6380.00±3935.17)pg/mL.Five of them had a gingival biopsy,5 were positive(positive rate was 100%),3 were subcutaneous fat biopsy,2 were positive(positive rate 66.7%),1 patient underwent renal biopsy was positive,All biopsy histopathological light microscopy was positive by Congo red special staining.Conclusion: Myocardial amyloidosis clinical manifestations of the lack of specificity,easy misdiagnosis,when patients with heart failure,unexplained pericardial effusion,ECG showed low limb lead voltage,and ventricular hypertrophy prompted ventricular septal and left ventricular wall uneven thickening,Should consider myocardial amyloidosis,endocardial biopsy helps to confirm the diagnosis.There is a lack of effective treatment.Emphasis on early diagnosis,timely treatment,prevention of complications,prolonging patient’s life. |
PDF Full Text Request