Cardiac amyloidosis evaluation by bedside ultrasound in the emergency department. A case report

Cardiac amyloidosis is a disease process of abnormal amyloid fibril deposition in cardiac muscle that can be diagnosed by specific electrocardiographic and echocardiographic findings. We present the case of a patient with a history of cardiac amyloidosis who presented to the emergency department (ED) with shortness of breath, and was diagnosed with a large pericardial effusion by ultrasonography. The patient's myocardium exhibited a granular, "sparkling" appearance with increased echogenicity, typical for cardiac amyloidosis. We discuss the bedside ultrasound findings characteristic of this infiltrative cardiomyopathy, and how they influenced the ED management and treatment plan for this patient.