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Patient
62-year-old woman with amyloid light-chain (AL) amyloidosis with renal and digestive involvement;
Trace
Sinus rhythm with low-voltage P wave; normal PR interval; clearly low-voltage QRS in limb leads (< 5mm in all limb leads); voltage slightly more elevated in precordial leads with a QRS complex > 10 mm in V3 and V4; pseudo-necrosis q wave pattern in V1-V2; repolarization disorders (flattened or negative T waves) in inferolateral leads;
Exergue
The diagnosis of cardiac amyloidosis should be evoked when faced with any patient with significant ultrasound hypertrophy in contrast with the highlighting of QRS complexes of normal amplitude or of low voltage on the ECG.
This patient has AL amyloidosis with renal, digestive and cardiac disorder. Amyloidosis is an infiltrative disease, with cardiac manifestations related to wall infiltration by amyloid deposits within the interstitial myocardial area.