Recruitment case on 11/11/19 was about a healthy patient presenting with heart failure – dyspnea, LE edema and rales, elevated JVD and positive hepatojugular reflex on exam. They had a history of carpal and cubital tunnel surgery a few months prior to presentation and also had subcutaneous bruising on exam. Evaluation including EKG, TTE and labs raised suspicion for amyloidosis which was proven by fat pad biopsy. Monoclonal spike was 0.1 g/dl (MGUS range). They were diuresed and discharged to outpatient hematology treatment with CyBorD. Some further information about heart failure and amyloidosis here: restrictive cardiomyopathy – 11.11
Teaching points:
-
Heart failure is a clinical diagnosis
-
Coronary artery disease is the most common reason for new onset heart failure
-
Except in recruitment lectures
-
Amyloidosis is one of the causes of restrictive cardiomyopathy. It has many other symptoms that can clue you in on the diagnosis
