A rare case of systemic AL-amyloidosis under the mask of myocardial infarction in the absence of myocardial hypertrophy: case report

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Abstract

Systemic amyloidosis is a group of diseases associated with extracellular deposition of fibrillar proteins, resulting in the loss of normal organ structure and function. AL-amyloidosis occurs when amyloid is deposited, consisting of full-length lambda or kappa immunoglobulin light chains, or fragments thereof. This article describes the complexity of timely diagnosis of systemic AL-amyloidosis with a predominant heart lesion in the absence of myocardial «hypertrophy» on the example of an elderly patient in whom the leading manifestation of the disease was heart failure with a preserved left ventricular ejection fraction.

About the authors

Svetlana A. Boldueva

Mechnikov North-Western State Medical University

Email: svetlanaboldueva@mail.ru
ORCID iD: 0000-0002-1898-084X

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg

Dmitriy S. Evdokimov

Mechnikov North-Western State Medical University

Email: kasabian244@gmail.com
ORCID iD: 0000-0002-3107-1691

Graduate Student

Russian Federation, Saint Petersburg

Marina V. Rozhdestvenskaya

LLC «AVA-PETER»

Email: samok-marina@yandex.ru
ORCID iD: 0000-0002-6298-547X

Cand. Sci. (Med.), Multidisciplinary Clinic «Scandinavia»

Russian Federation, Saint Petersburg

Sergey A. Vinnichuk

Mechnikov North-Western State Medical University

Email: Sergei.Vinnichuk@szgmu.ru
ORCID iD: 0000-0002-9590-6678

Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Lyubov B. Mitrofanova

Almazov National Medical Research Centre

Author for correspondence.
Email: lubamitr@yandex.ru
ORCID iD: 0000-0003-0735-7822

D. Sci. (Med.), Assoc. Prof.

Russian Federation, Saint Petersburg

References

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Supplementary files

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2. Fig. 1. Patient M. EKG upon admission.

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3. Fig. 2. Patient M. EoCG on admittance. There is no thickening of the walls of the left ventricle (arrow indicates an interventricular septum).

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4. Fig. 3. Patient M. ’s EKG is moving.

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5. Fig. 4. Perivascular amyloid deposition based on histological studies. Magnification 100. Congo red.

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6. Fig. 5. Perivascular amyloid deposition based on histological studies. Magnification 20. Congo coloration red. Microscopy in polarized light. Myocardium.

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