伴心肌肌钙蛋白I持续升高和心绞痛症状的系统性淀粉样变性

系统性淀粉样变性相对少见，累及心脏时，可出现多种临床表现，极易造成误诊和漏诊。本例报道了一位66岁女性，表现为持续性肌钙蛋白I升高和反复发作的胸痛，根据心脏影像学检查，结合单克隆免疫球蛋白试验及骨髓细胞学和骨髓活检，最终诊断为“系统性淀粉样变性（心脏受累）”。因此，对于射血分数保留的不能解释原因的心衰、肌钙蛋白升高、心脏影像学异常或存在系统性疾病，均应警惕有无淀粉样变可能。

cardiac amyloidosis presenting with continuous elevations of cardiac troponin I and angina pectoris

Systemic amyloidosis is relatively rare and cardiac involvement can cause a variety of clinical manifestations, leading to requently misdiagnosis and missed diagnosis. In this study, we present a case of a 66-year-old woman with continuous elevated troponin I levels and recurrent chest pains. The final diagnosis of systemic amyloidosis with heart involvement was made by cardiac imaging tests, monoclonal immunoglobulin assay, bone marrow cytology and marrow biopsy. Therefore, heart failure with preserved ejetion fraction, elevated troponin levels, abnormal cardiac imagings or with concomitant systemic disease should be vigilant for amyloidosis.