CLINICAL INTRODUCTION

An elderly patient was known with generalised osteoarthritis and destruction of the right hip. Six months before, this patient was admitted to a general hospital because of oedema and ventricular tachycardia. No coronary artery disease was found on coronary angiogram and the tachycardia was successfully converted to sinus rhythm. MRI 3 months later showed diffuse asymmetric hypertrophy of the right and LV walls, with diffuse subendocardial and midwall late gadolinium enhancement, and a diminished LVEF of 35%, indicating a restrictive cardiomyopathy.

At referral to our hospital, the only complaints were fatigue and dyspnoea when climbing the stairs. Physical examination showed no additional abnormalities. Serum analysis revealed elevated levels of N-terminal …