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  • Cardiac AL amyloidosis presenting as recurrent dyspnoea in a patient with cancer: an important clinical clue to an early diagnosis

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Case Reports: Reminder of important clinical lesson
Cardiac AL amyloidosis presenting as recurrent dyspnoea in a patient with cancer: an important clinical clue to an early diagnosis
  1. Giselle Alexandra Suero-Abreu1,2,
  2. Phillip Lim1,
  3. Brijesh Patel3 and
  4. Renjit Thomas3
  1. 1Medicine, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
  2. 2Cardiovascular Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Cardiovascular Medicine, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
  1. Correspondence to Dr Giselle Alexandra Suero-Abreu; giselle.suero{at}gmail.com

Abstract

Cardiac amyloidosis (CA) is challenging to diagnose due to its non-specific clinical manifestations early in the disease process. We report the case of a patient who presented with dyspnoea, abdominal distension and leg swelling. Medical history was notable for hypertension, recurrent vulvar squamous cell carcinoma and polysubstance abuse. Over 1 year before the official diagnosis of CA, the patient had multiple hospital readmissions for dyspnoea. Our case illustrates the importance of having a high index of clinical suspicion for an early diagnosis of CA. Furthermore, it highlights the need to re-evaluate a presumed diagnosis when a patient’s symptoms recur or do not respond to appropriate treatment and to consider the influence of social factors on diagnostic processes.

  • Heart failure
  • General practice / family medicine
  • Cancer - see Oncology
  • Gynecological cancer
  • cardio-oncology
  • cardiac amyloidosis

https://doi.org/10.1136/bcr-2021-245969

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    Footnotes

    • Twitter @GiselleSA_MDPhD

    • Contributors GAS-A contributed to the care of the patient and drafted and revised the initial manuscript. PL reviewed the literature and contributed to manuscript draft. BP and RT contributed to the care of the patient and to the revision of the manuscript. All authors approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.