Open AccessMitral and tricuspid stenosis caused by light chain cardiac amyloid deposition
Author(s) -
Randhawa Varinder K.,
Vakamudi Sneha,
Phelan Dermot M.,
Samaras Christy J.,
McKenney Jesse K.,
Hanna Mazen,
Perez Antonio L.
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12668
Subject(s) - medicine , cardiology , cardiac amyloidosis , amyloidosis , heart failure , tricuspid valve , pericardial effusion , cardiomyopathy , stenosis , restrictive cardiomyopathy , valvular heart disease , tricuspid stenosis , cardiac resynchronization therapy , ejection fraction
Abstract Cardiac amyloidosis results in an infiltrative restrictive cardiomyopathy, with a number of characteristic features: biventricular hypertrophy, abnormal myocardial global longitudinal strain with relative apical sparing, biatrial dilation, and small pericardial effusion along with conduction abnormalities. Amyloid deposits leading to hemodynamically significant valvular heart disease are very rare. We describe a rare case of concomitant moderately severe tricuspid and mitral valve stenosis because of ongoing amyloid deposition in a patient with progressive multiple myeloma and fat pad biopsy‐proven light chain amyloidosis. Worsening infiltrative cardiomyopathy and valvulopathy despite evidence‐based chemotherapy and heart failure pharmacotherapy led to end‐stage disease and death. Valvular involvement in cardiac amyloidosis requires early recognition of the underlying disease condition to guide directed medical therapy and prevent its progression. In this instance, valvuloplasty or valve replacement is not a viable option.