PMC4527338_01
Electrocardiogram revealed sinus rhythm, low voltages in limb leads, QS waves indicative of pseudoinfarction in precordial and inferior leads, first-degree atrioventricular block, and prolonged QTc.
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Electrocardiogram (ECG) revealed sinus rhythm, low voltages in limb leads, QS waves in precordial and inferior leads, first-degree atrioventricular block, and prolonged QTc (Figure 1).
A four-chamber apical view echocardiogram showing biatrial dilatation, valve thickening, thick ventricular walls (left ventricular wall is 15 mm and interventricular septum is 19 mm), and interventricular septum with speckled appearance, which suggests amyloid infiltrate.. Abbreviations: RV, right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium.
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Two-dimensional echocardiography revealed marked concentrically thickened and speckled appearance of ventricular walls, biatrial dilatation, and left ventricular ejection fraction of 70% (Figure 2).
Rectum biopsy: amyloid deposits are confirmed by a positive Congo red stain (arrow), which gives the characteristic salmon pink color (200x).
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Rectum biopsy confirmed amyloid infiltrate (Figure 3).