Cardiac amyloidosis presenting as pulmonary arterial hypertension: A case report

Figure 1 Serial changes on electrocardiography and echocardiography. A: Electrocardiography (ECG) demonstrated a left anterior fascicular block, poor R-wave progression in leads V1-V3, and a non-specific T wave and ST-segment; B: 11 mo later, ECG demonstrated a new left bundle branch block, ST-segment depression in leads I and augmented unipolar limb lead (AVL) and T wave inversion in leads I, AVL, and V4-V6; C: 21 mo later, ECG demonstrated atrial fibrillation, left bundle branch block with wider QRS wave group, ST segment elevation in leads V1-V3, and T wave inversion in leads I, AVL and V4-V6; D: Echocardiography revealed characteristic sparkling and a granular texture in the ventricle wall; E: Pacing ECG was showed; F: Echocardiography revealed atrial enlargements and worsening systolic dysfunction (ejection fraction 48%).