Case report: recurrent chest pain as initial manifestation of rapidly progressing light-chain cardiac amyloidosis with microvascular infiltration-a novel red flag associated with poor outcomes.

Carla Indennidate, Aldostefano Porcari, Rossana Bussani, Marco Merlo, Gianfranco Sinagra

Abstract readCase Reports

In one paragraph

Article in European heart journal. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Carla IndennidateCenter for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Via Valdoni 7, 34149 Trieste, Italy.ORCID https://orcid.org/0009-0006-0012-5542

Aldostefano PorcariCenter for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Via Valdoni 7, 34149 Trieste, Italy.

Rossana BussaniInstitute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Via Valdoni 7, 34149 Trieste, Italy.

Marco MerloCenter for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Via Valdoni 7, 34149 Trieste, Italy.

Gianfranco SinagraCenter for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Via Valdoni 7, 34149 Trieste, Italy.ORCID https://orcid.org/0000-0003-2700-8478

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Angina due to microvascular amyloid infiltration is an under-recognized early red flag of infiltrative disease and should be investigated as a predictor of poor outcomes. Case summary: A 73-year-old man with cardiovascular risk factors and a history of treated obstructive coronary artery disease presented 10 months later with recurrent angina. His condition progressively worsened, with the development of severe dyspnoea. Within 6 months, he succumbed to cardiogenic shock in the presence of severe biventricular dysfunction and unobstructed coronary arteries. Post-mortem diagnosis revealed AL cardiac amyloidosis with massive myocardial infiltration and extensive microvascular amyloid deposits. Discussion: This case underscores chest pain as a critical clinical marker, potentially indicating microvascular amyloid infiltration in patients with light-chain cardiac amyloidosis, particularly those with unobstructed coronary arteries. Its assessment may also have implications for future therapies.

Indexed as

AmyloidosisCase reportFatal cardiac amyloidosisMicrovascular dysfunctionMicrovascular infiltrationRecurrent angina

Identifiers

PMID41306480

DOI10.1093/ehjcr/ytaf521

PMCPMC12646144

What OpenQuestion holds

Textmetadata

LicenceCC BY

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.