case_images: PMC8526272_01
case_images: Previous echocardiogram (a). Parasternal long axis (b). Parasternal short axis (c). Apical four-chamber showing moderate concentric left ventricular hypertrophy, right ventricular dilation, and moderately dilated atria.
case_images: CRIC2021-5673364.001.jpg
case_images: PMC8526272_01_CRIC2021-5673364.001.jpg
case_images: fig1
case_images: Previous echocardiograms (Figure 1) had shown moderate concentric left ventricular hypertrophy, normal ejection fraction, hypokinesis of basoseptal left ventricular wall, with right ventricular dilation, moderately dilated atria, and pulmonary hypertension at around 40 mmHg; tissue Doppler was not performed.
case_images: Echocardiogram (a). Parasternal long axis (b). Parasternal short axis (c). Apical two-chamber of left ventricle and (d) tissue Doppler showing severe left ventricular hypertrophy and diastolic dysfunction.
case_images: CRIC2021-5673364.002.jpg
case_images: PMC8526272_01_CRIC2021-5673364.002.jpg
case_images: fig2
case_images: Echocardiographic strain analysis showing a relative sparing of the apex compared to the bases.
case_images: CRIC2021-5673364.003.jpg
case_images: PMC8526272_01_CRIC2021-5673364.003.jpg
case_images: fig3
case_images: Cardiac magnetic resonance; (a) left ventricle hypertrophy, (b) abnormal nulling of the myocardium.
case_images: CRIC2021-5673364.004.jpg
case_images: PMC8526272_01_CRIC2021-5673364.004.jpg
case_images: fig4
case_images: Cardiac biopsy with Congo red stain, demonstrating apple green birefringence in polarized light, consistent with amyloidosis.
case_images: CRIC2021-5673364.005.jpg
case_images: PMC8526272_01_CRIC2021-5673364.005.jpg
case_images: fig5
case_images: Finally, a cardiac biopsy was positive for amyloid with Congo red staining (Figure 5) and demonstrated AL amyloid on mass spectrometry.