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Case 7
Presented by: Prof. P Bruneval
Clinical History
A 42-year-old male patient was transferred to the university hospital for endomyocardial
biopsy. This heavy smoker had heart palpitation for 1 year. He presented with shortness of breath at effort for 3 months and was referred to a cardiologist. At this time, main findings were: supraventricular tachycardia and right branch bundleblock at ECG, normal urine and blood biology ( including thyroid hormones) except for a mild hypogammaglobulinemia, left ventricle hypertrophy and hypocontractility without dilatation at transesophageal echo and at RMI. Echo and RMI patterns of the left ventricle myocardium were suggestive of amyloidosis. However, a labial salivary gland biopsy stained with Congo red was negative. At the university hospital, a coronary angiogarphy showed normal coronary arteries. During this procedure, a left ventricle endomyocardial biopsy was performed and is presented here. Arrhythmia treatment required a pace-maker implantation 1month later. Cardiac failure rapidly worsened and 3 months later after a brief emergency extracorporeal assist device, a cardiac transplantation was performed.
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Light chain disease or Randall disease
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28.12.2007 |
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