Summary

A 73-year-old man was admitted to the cardiology department with unstable angina. He had a history of macroglossia with 3 years of development, attributed to hypothyroidism. On physical examination, he presented an exuberant macroglossia. The following diagnostic procedures were performed—ECG, in sinus rhythm with low voltage criteria, and transthoracic echocardiography, which revealed a left ventricle with preserved function and marked wall thickening, with low strain values in basal segments. The coronary angiography confirmed a lesion of 90% in the right coronary artery, treated with two stents. Suspecting a systemic infiltrative disease, additional tests were performed and these revealed the presence of systemic amyloid light-chain (AL) amyloidosis with cardiac involvement, associated with multiple myeloma. The patient was sent to a consult of haematology to begin chemotherapy.