1. Acute cardiac tamponade in light-chain amyloidosis
- Author
-
George Mount and Mikhail Kuprian
- Subjects
medicine.medical_specialty ,Heart Diseases ,medicine.medical_treatment ,Pericardial effusion ,Article ,Electrocardiography ,Fatal Outcome ,Cardiac tamponade ,Internal medicine ,Medicine ,Humans ,Aged ,medicine.diagnostic_test ,business.industry ,Amyloidosis ,General Medicine ,medicine.disease ,Cardiac Tamponade ,Effusion ,Cardiac amyloidosis ,Pericardiocentesis ,Echocardiography ,Cardiology ,Female ,Immunoglobulin Light Chains ,business ,Rare disease - Abstract
A 71-year-old woman, with a history of light-chain amyloidosis, presented with a sudden onset dyspnoea. Echocardiography showed a large pericardial effusion with compression of the right atrium and the right ventricle. Right heart catheterisation demonstrated equalisation of her diastolic pressures consistent with cardiac tamponade. Pericardiocentesis revealed a haemmorrhagic exudative effusion with no evidence of malignancy. Bone marrow biopsy and other investigations showed no evidence of multiple myeloma. Her effusion recurred 2 weeks later and repeat pericardiocentesis demonstrated similar findings. She was started on chemotherapy with no further recurrence of pericardial effusion. The patient was unable to tolerate chemotherapy and died 1 year after initial presentation. This case represents a rare manifestation of cardiac amyloidosis and explores the reported aetiologies for cardiac tamponade in the setting of light-chain amyloidosis. Acute and definitive treatments are also discussed.
- Published
- 2014