Clinical studySymptomatic ischemic heart disease resulting from obstructive intramural coronary amyloidosis
Section snippets
Material and methods
A computerized search of the medical records of all patients seen at the Mayo Clinic in Rochester, Minnesota, with the diagnoses of primary amyloidosis and angina pectoris, myocardial infarction, or other diagnosis suggestive of ischemic heart disease was done for the period from January 1, 1960, to June 1, 1999. Permission to perform a retrospective review of the medical records was granted by the Institutional Review Board of the Mayo Foundation in compliance with federal regulations. Of the
Results
The demographic, clinical, and pathologic features of the 11 patients (8 men, 3 women) are found in Table 1, Table 2, Table 3. ECG Changes after Onset of Symptoms of Ischemia Functional Study Coronary Angiogram Echocardiogram Time from Onset of Ischemic Symptoms to Death or Transplant (Months) Clinical Cause of Death Left bundle branch block, left ventricular hypertrophy, increased voltage, ventricular tachycardia Normal Left ventricular ejection fraction 47%, thick septum, new infarction 8 Amyloid
Discussion
A MEDLINE search (1966 to the present), using the key words “amyloidosis,” “angina pectoris,” “cardiomyopathy,” “ischemic heart disease,” and “nonatherosclerotic coronary artery disease,” was conducted to identify published cases of symptomatic heart disease resulting from obstructive intramural coronary amyloidosis. The references of acquired articles were searched. We identified 11 additional cases 8, 9, 10, 11, 12, 13, 14, 15, 16 using the same criteria as in our series. Other reports 2, 17,
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