Clinical Features And Pathology Research Of Cardiac Amyloidosis

Objective: Summarizes the characteristics of cardiac amyloidosis, clinicalmanifestations and laboratory examination of patients to improve clinicalunderstanding of cardiac amyloidosis. Improve the diagnosis rate.Methods: Review Analysis9Month-November2014visit to the FirstHospital of Jilin University, Department of Cardiology of four patients, aged50-76years, all patients were excluded other serious heart, liver, kidney, lungand other diseases. All patients underwent detailed clinical data collection,including: general, clinical symptoms and physical examinations, Circulation,urine, liver, kidney and other routine laboratory tests, and echocardiography,ECG, IFE,24h urinary light chain testing, bone marrow aspiration+biopsy,cardiac, kidney, liver, abdominal, neck and other parts of the biopsy results, toconsider whether associated with other effusion, etc., for the patients with heartfailure in patients with New York Heart Association class and throughpathologic examination: examination: HE staining, electron microscopy andspecial staining: Congo red staining, polarized light and immunohistochemistry(Max Vision, etc.), flow cytometry pathology.Results:1.⑴biopsy after HE staining pink, amorphous, waxy, withcharacteristic crack; Electron microscope, randomly arranged fibrils structure;plasmacytosis surrounding sediments and may express consistent with amyloiddeposits light chain restriction.⑵Congo red staining: was brick red colorunder polarized light showed characteristics of and apple green birefringence.⑶Immunohistochemical detection: λ light chain positive. flow cytometry:immunoglobulin light chain restriction and abnormal phenotype of bonemarrow plasma cell clone detection of abnormal plasma cells.2,4in both casesdue to chest tightness, shortness of breath onset, and have the performance ofright ventricular dysfunction (jugular vein distention, lower extremity edema, etc.), and proteinuria and other symptoms, which due to amyloidosis causedTwo patients had increased liver, cardiac arrhythmias and other characteristics.A few patients experience skin petechiae, ecchymosis and other clinicalmanifestations. Cardiac amyloidosis is a multi-system disease, a simpleanti-heart failure therapy, often combined with kidney damage and lung, liverand other organ damage.3. There are two cases of patients with pericardialeffusion, ascites2patients,2patients with pleural effusion, including threepatients with concomitant multiple effusion. There are circumstances indicatingthat most patients with multiple serous effusions.4. In all patients left atrialenlargement, including two patients with right atrial enlargement, three patientsthickened septum thickness, left ventricular posterior wall thickening of the leftventricle in patients with no increase in blood pressure. Echocardiographymulti-display, simple atrial enlargement, and ventricular cavity or ventricularnot appear granular echo shine. Multi-atrial septal thickening and septalthickening;4patients were urinary light chain change occurs24h.Conclusion:1, Clinical characteristics of cardiac amyloidosis patientsshowed more variability of diastolic heart failure.2, Patients with cardiacamyloidosis electrocardiogram showed more limb leads low voltage,echocardiography myocardial echo enhancement (particle shine), or theperformance of cardiac hypertrophy. ECG and echocardiography performanceperformance contradictions.3,patients with cardiac amyloidosis and more withmultiple organ dysfunction and proteinuria.4, Amyloid pathology clinicalfeatures of amyloid deposition footprint and lead to tissue damage.