E2780. Elusive Heart: A Multimodality Review of Cardiac Amyloidosis
Authors
Imran Ahmed;
University of Cincinnati
Bruce Mahoney;
University of Cincinnati
Background
Cardiac amyloidosis is caused by the abnormal deposition of amyloid fibrils in cardiac tissue, leading to restrictive infiltrating cardiomyopathy. Cardiac involvement in patients with systemic amyloidosis has important prognostic implications. An accurate diagnosis by the radiologist can have a significant impact on patient care.
Educational Goals / Teaching Points
As an example, we present a case of a 55-year-old man who presented with symptoms of heart failure and was found to have cardiac amyloidosis. The complete patient course will be described in detail in the exhibit. We will discuss the demographics, clinical presentation, diagnosis, treatment, and prognosis of cardiac amyloidosis. A multimodality review of imaging findings and helpful clues will also be discussed.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This case from our institution shows an example of cardiac amyloidosis diagnosed with nuclear medicine Tc-99m pyrophosphate scintigraphy to identify ATTR cardiac amyloidosis using quantitative and semiquantitative visual assessments. On cardiac MRI, concentric left ventricular thickening with late gadolinium enhancement (LGE) is 80% sensitive and 94% specific for cardiac amyloidosis. Nuclear medicine and cardiac MRI protocols for detection of cardiac amyloidosis will be discussed.
Conclusion
Patients with cardiac amyloidosis often present with heart failure, conduction abnormalities and even sudden death. Timely diagnosis is critical to improve prognosis in these patients.
