To report a case of light chain cardiac amyloidosis with bilateral atrial appendage thrombosis and its clinical course.
Approach:
Case Presentation: A 70-year-old woman with a history of progressive exertional dyspnea and recurrent syncope was diagnosed with light chain cardiac amyloidosis and bilateral atrial appendage thrombosis.
Diagnostic Evaluation: The patient underwent various diagnostic tests including echocardiography, cardiac MRI, and CT angiography, which confirmed the presence of cardiac amyloidosis and thrombi.
Treatment: The patient was treated with anticoagulation, heart failure medications, and a pacemaker, but declined chemotherapy due to financial constraints.
Follow-up: Follow-up via telephone indicated initial improvement, but the patient later discontinued medications and died from refractory heart failure.
Key Findings:
The patient exhibited bilateral atrial appendage thrombosis associated with light chain cardiac amyloidosis.
Despite initial treatment, the patient experienced rapid clinical deterioration and ultimately died from refractory heart failure.
Interpretation:
This case illustrates the challenges in managing complications associated with light chain cardiac amyloidosis.
Limitations:
No repeat imaging was performed during follow-up, which limited the assessment of the patient's condition.
Follow-up assessments were conducted via telephone, limiting clinical evaluation.
Conclusion:
This case highlights the need for early recognition and intervention in light chain cardiac amyloidosis.
