A 58-year-old woman diagnosed with stage IV rheumatoid arthritis, secondary amyloidosis, chronic renal failure and hypertension.
She was admitted as an emergency due to congestive heart failure. Echocardiographic study showed a mitral valve with probable rupture of chordae tendinous cord and ultrasound images suggestive of tendinous insufficiency.
With the diagnosis of heart failure due to endocarditis, treatment with antibiotics and diuretics was established, reason why catheterization was performed, starting two days later with intense hematuria that caused a large demonstrated bladder clot.
Under general anesthesia, transurethral hematoma evacuation was performed, observing all inflamed bladder mucosa, bleeding, obtaining multiple biopsies and electrocoagulating the wall.
In the immediate postoperative period, the patient developed cardiorespiratory arrest associated with exitus (30/06/1996).
The pathological diagnosis was bladder amyloidosis (AA).
