Title:Cardiac Amyloid - A Hidden Contributor to Cardiac Dysfunction Following Cardiac Surgery: Case Report and Literature Review
Volume: 16
Issue: 4
Author(s): Trevor A. Flood , Scott H. Bradshaw, John P. Veinot and Vidhya Nair*
Affiliation:
- Division of Anatomical Pathology, Department of Pathology and Laboratory Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, ON K1H 8L6,Canada
Keywords:
Amyloid, cardiomyopathy, pathology, myocardial, surgery, complications.
Abstract: We present two patients who underwent cardiac surgery followed by post-operative low
cardiac output, diastolic dysfunction and resistance to inotropic support. Despite aggressive medical
management, both patients died. At autopsy, the hearts were enlarged and showed previously undiagnosed
myocardial and vascular amyloidosis. Occult cardiac amyloidosis is an uncommon, often
occult, contributor to post-operative complications post cardiac surgery. Pre-operative or intraoperative
myocardial biopsy may be useful in patients with unexplained diastolic dysfunction.
Brief Summary: We present two patients who underwent cardiac surgery followed by low cardiac
output, diastolic dysfunction and resistance to inotropic support. Cardiac dysfunction was due to
occult amyloidosis. Pre-operative or intra-operative myocardial biopsy may be useful in patients
with unexplained diastolic dysfunction. With recent therapy advances, classification and possible
treatment of amyloid are possible.
