Cardiac amyloidosis

Abstract

Background: Cardiac amyloidosis is a rare condition often recognised as restrictive cardiomyopathy caused by extracellular accumulation of proteins in the myocardium. A more seldom form is amyloidoma, a solitary, localised tumour-like deposition of amyloid.

Case presentation: A man in his forties presented with lethargy, chest discomfort and fever over the preceding three weeks. Transoesophageal echocardiography (TEE) revealed an intracardiac tumour causing severe obstruction and secondary increased diastolic pressure gradient between the left atrium and ventricle. Emergency surgery revealed large tumour masses in both atria, predominantly on the left side. The patient died perioperatively within 24 hours of admission to the local hospital. Histopathological examination confirmed the diagnosis of amyloidoma.

Interpretation: Cardiac amyloidoma is an extremely rare finding that can lead to severe haemodynamic compromise. This case highlights the importance of considering cardiac tumours in young adults with atypical cardiac symptoms and urgent investigation with TEE.