case_images: PMC9946906_01
case_images: Echocardiogram. Apical four-chamber view showing increased left ventricular septal wall thickness (blue star) and bi-atrial enlargement. The ejection fraction here was 27%, and there was severe diastolic dysfunction
case_images: cureus-0015-00000034107-i01.jpg
case_images: PMC9946906_01_cureus-0015-00000034107-i01.jpg
case_images: FIG1
case_images: Over this period of time, her ejection fraction was 20%-30%, and her septal thickness was 1.5 cm (Figure 1).
case_images: PMC9946906_02
case_images: Global longitudinal strain analysis. Global longitudinal strain is -7% in this patient, and the polar map shows a characteristic apical sparing pattern consistent with cardiac amyloidosis. ANT, anterior; ANTS, anteroseptal; INFS, inferoseptal; INF, inferior; INFL, inferolateral; ANTL, anterolateral
case_images: cureus-0015-00000034107-i02.jpg
case_images: PMC9946906_02_cureus-0015-00000034107-i02.jpg
case_images: FIG2
case_images: Echocardiography showed ejection fraction of 36%, septal thickness of 1.3 cm, and reduced global longitudinal strain with a characteristic apical sparing pattern (Figure 2).
case_images: PMC9946906_03
case_images: Cardiac magnetic resonance imaging (MRI). A diffuse subendocardial late gadolinium enhancement pattern is noted in the short axis (A) and four-chamber (B) images on this cardiac MRI. The arrows point to the white subendocardial stripe of late gadolinium enhancement in the anterolateral wall
case_images: cureus-0015-00000034107-i03.jpg
case_images: PMC9946906_03_cureus-0015-00000034107-i03.jpg
case_images: FIG3
case_images: Echocardiogram showed ejection fraction of 35% and septal thickness of 1.8 cm, and cardiac magnetic resonance imaging (MRI) showed diffuse subendocardial late gadolinium enhancement consistent with amyloidosis (Figure 3).
case_images: PMC9946906_04
case_images: Electrocardiogram. A 12-lead electrocardiogram demonstrating normal sinus rhythm with diffuse low voltage, incomplete right bundle block, and a pseudoinfarct pattern in anterior and inferior leads. aVR, augmented vector right; aVL, augmented vector left; aVF, augmented vector foot
case_images: cureus-0015-00000034107-i04.jpg
case_images: PMC9946906_04_cureus-0015-00000034107-i04.jpg
case_images: FIG4
case_images: Electrocardiogram showed sinus rhythm with first-degree atrioventricular (AV) block and diffusely low voltage (Figure 4).