Limits...
Case 6/2014--A case of a 61-year-old woman with diastolic heart failure.

Pitta FG, Olivetti NQ, Peniche DS, Dercht AM, Gutierrez PS, Benvenuti LA - Arq. Bras. Cardiol. (2014)

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração, HC-FM, USP, São Paulo, SP, Brazil.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Patient MSV, a 61-year-old woman born in Penteado, Alagoas, Brazil and residing in SãoPaulo was hospitalized for decompensated heart failure (HF)... After analyzing the complementary tests, a significant worsening of renal function wasnoted in relation to the tests performed in March, as well as a significant drop inhemoglobin values, indicating anemia and acute renal failure... The U/Cr ratio remained< 40, and type I urine results revealed the presence of significant proteinuria,suggesting a parenchymatous process for renal dysfunction... Another relevant fact is theelevation of the myocardial necrosis markers, which may be associated with coronarydisease or, more likely, with the kidney disease and decompensated HF, because thepatient did not present significant risk factors for ischemic cardiovascular disease... The ECG showed low QRS voltage, most evident in the frontal plane, late R waveprogression in the horizontal plane, and diffuse changes in ventricular repolarization.This pattern can be found in some diseases such as decompensated hypothyroidism,pericardial effusion, and chronic obstructive pulmonary disease, in addition toinfiltrative cardiomyopathies... This examination ruled out the presence of pericardialeffusion, showing significant left ventricular hypertrophy with some degree ofasymmetry, in addition to indirect signs of restrictive cardiomyopathy... Myocardial hypertrophy is oftenassociated with hypertension or hypertrophic cardiomyopathy, but both involve normal orincreased voltage on the ECG; and therefore, the findings of ventricular hypertrophyassociated with reduced voltage on the ECG in the absence of pericardial effusion areunique to infiltrative cardiomyopathies, a group of cardiac diseases within therestrictive cardiomyopathies... In the right ventricular involvement, signs of right-side HF predominated withelevated jugular venous pressure, peripheral edema, and ascites... Amyloidosis is a rare disease characterized by deposits that correspond to less than 30proteins, assuming anomalous conformation... Type AA amyloidosis usually does notsignificantly compromise the heart, accompanying chronic inflammatory diseases that thepatient did not have... The bone marrow was hypercellular; it was neitherpossible to eliminate nor characterize the plasmacytic dyscrasia with certainty, whichin any case had no direct connection with amyloidosis... As for transthyretin, we do nothave its specific antibody.

Show MeSH

Related in: MedlinePlus

Histological slides showing amyloid deposits outside the cardiovascular system:tongue (left panel) and skin (right panel).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4290747&req=5

f08: Histological slides showing amyloid deposits outside the cardiovascular system:tongue (left panel) and skin (right panel).

Mentions: The microscopic study revealed the presence of amyloid material in the intramyocardialcoronary branches; the endocardium and myocardium; particularly, the subendocardialregion, the pulmonary artery; and in part of its intraparenchymal branches, the vesselsof the renal hilum, and the glomerular capillaries, on the wall of splenic vessels andhepatic portal spaces (Figure 7). Amyloidsubstance was also found in the skin, tongue, bladder, and most markedly, in themyometrium and the muscular layer of the digestive tract (Figure 8).


Case 6/2014--A case of a 61-year-old woman with diastolic heart failure.

Pitta FG, Olivetti NQ, Peniche DS, Dercht AM, Gutierrez PS, Benvenuti LA - Arq. Bras. Cardiol. (2014)

Histological slides showing amyloid deposits outside the cardiovascular system:tongue (left panel) and skin (right panel).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4290747&req=5

f08: Histological slides showing amyloid deposits outside the cardiovascular system:tongue (left panel) and skin (right panel).
Mentions: The microscopic study revealed the presence of amyloid material in the intramyocardialcoronary branches; the endocardium and myocardium; particularly, the subendocardialregion, the pulmonary artery; and in part of its intraparenchymal branches, the vesselsof the renal hilum, and the glomerular capillaries, on the wall of splenic vessels andhepatic portal spaces (Figure 7). Amyloidsubstance was also found in the skin, tongue, bladder, and most markedly, in themyometrium and the muscular layer of the digestive tract (Figure 8).

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração, HC-FM, USP, São Paulo, SP, Brazil.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Patient MSV, a 61-year-old woman born in Penteado, Alagoas, Brazil and residing in SãoPaulo was hospitalized for decompensated heart failure (HF)... After analyzing the complementary tests, a significant worsening of renal function wasnoted in relation to the tests performed in March, as well as a significant drop inhemoglobin values, indicating anemia and acute renal failure... The U/Cr ratio remained< 40, and type I urine results revealed the presence of significant proteinuria,suggesting a parenchymatous process for renal dysfunction... Another relevant fact is theelevation of the myocardial necrosis markers, which may be associated with coronarydisease or, more likely, with the kidney disease and decompensated HF, because thepatient did not present significant risk factors for ischemic cardiovascular disease... The ECG showed low QRS voltage, most evident in the frontal plane, late R waveprogression in the horizontal plane, and diffuse changes in ventricular repolarization.This pattern can be found in some diseases such as decompensated hypothyroidism,pericardial effusion, and chronic obstructive pulmonary disease, in addition toinfiltrative cardiomyopathies... This examination ruled out the presence of pericardialeffusion, showing significant left ventricular hypertrophy with some degree ofasymmetry, in addition to indirect signs of restrictive cardiomyopathy... Myocardial hypertrophy is oftenassociated with hypertension or hypertrophic cardiomyopathy, but both involve normal orincreased voltage on the ECG; and therefore, the findings of ventricular hypertrophyassociated with reduced voltage on the ECG in the absence of pericardial effusion areunique to infiltrative cardiomyopathies, a group of cardiac diseases within therestrictive cardiomyopathies... In the right ventricular involvement, signs of right-side HF predominated withelevated jugular venous pressure, peripheral edema, and ascites... Amyloidosis is a rare disease characterized by deposits that correspond to less than 30proteins, assuming anomalous conformation... Type AA amyloidosis usually does notsignificantly compromise the heart, accompanying chronic inflammatory diseases that thepatient did not have... The bone marrow was hypercellular; it was neitherpossible to eliminate nor characterize the plasmacytic dyscrasia with certainty, whichin any case had no direct connection with amyloidosis... As for transthyretin, we do nothave its specific antibody.

Show MeSH
Related in: MedlinePlus