Boda I, Farhoud H, Dalia T, Goyal A, Shah Z, Vidic A. Early and aggressive presentation of wild-type transthyretin amyloid cardiomyopathy: A case report. World J Cardiol 2022; 14(12): 657-664 [PMID: 36605423 DOI: 10.4330/wjc.v14.i12.657]
Corresponding Author of This Article
Andrija Vidic, DO, Department of Cardiovascular Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, United States. avidic@kumc.edu
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ilham Boda, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
Hassan Farhoud, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
Tarun Dalia, Amandeep Goyal, Zubair Shah, Andrija Vidic, Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
Author contributions: Boda I contributed to manuscript writing, editing, and data collection; Farhoud H assisted with writing and edits; Dalia T and Goyal A assisted with edits; Shah Z and Vidic A have contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrija Vidic, DO, Department of Cardiovascular Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, United States. avidic@kumc.edu
Received: September 8, 2022 Peer-review started: September 8, 2022 First decision: October 13, 2022 Revised: November 3, 2022 Accepted: November 22, 2022 Article in press: November 22, 2022 Published online: December 26, 2022 Processing time: 101 Days and 11.5 Hours
Core Tip
Core Tip: Wild-type transthyretin amyloidosis (ATTRwt) continues to be an underdiagnosed condition. Although rare in patients under 60 years of age, physicians should include the condition in their differential as early diagnosis and early management can impact patient outcomes. Physicians should be aware of the findings on non-invasive testing that supports ATTRwt. Classically on echocardiogram, cardiac amyloidosis can present as thickened ventricular walls, small lehigh valley chamber, biatrial enlargement, apical sparing on longitudinal strain and signs of elevated filling pressures and restrictive diastolic physiology (increased E/A ratio, E/e’ and reduced mitral annular tissue velocities). Cardiac magnetic resonance imaging classically shows late gadolinium enhancement. A technetium pyrophosphate study shows an increased heart-to-contralateral ratio and increased Perugini visual grade.
