Persistent Troponin Elevation in a Patient with Cardiac Amyloidosis |
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| Authors: | Bjoern F. Kraemer MD Peter Seizer MD Tobias Geisler MD Karin Klingel MD Reinhard Kandolf MD Stephan Lindemann MD Meinrad Gawaz MD |
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| Affiliation: | 1. Medizische Klinik III, University Hospital of Tübingen, Otfried‐Müller‐Str, Tübingen, Germany;2. Department of Molecular Pathology, Institute of Pathology, University Hospital of Tübingen, Liebermeisterstr, Tübingen, Germany;3. Email:stephan.lindemann@med.uni‐ tuebingen.de |
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| Abstract: | A 79‐year‐old patient repeatedly presented with chest discomfort and dyspnea on exertion. With echocardiography a prominent left ventricular and septal hypertrophy was detected with reduced left ventricular function. Despite successful revascularization and excellent results after stenting, the patient showed persistently elevated troponin levels. To investigate the abnormal findings of persistent troponin elevation, septal hypertrophy, and heart failure we performed endomyocardial biopsies which showed widespread myocardial amyloidosis. Amyloid subtyping revealed transthyretin amyloidosis. This is the first case showing persistent troponin elevation in a patient with tranthyretin amyloidosis. Very few other cases have been published on the topic of cardiac amyloidosis and troponin elevation so far. Our case serves as an illustrating example in the differential diagnosis of nonischemic causes of persistent troponin elevation. It is important to consider cardiac amyloidosis in patients with troponin elevation and heart failure since the clinical management differs significantly from other causes of heart failure. Copyright © 2009 Wiley Periodicals, Inc. |
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| Keywords: | cardiac amyloidosis troponin heart failure syncope |
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