Nursing role in early detection of cardiac amyloidosis: a case report

  • Authors

    • Noof Eid Al shammari RN
  • Cardiac amyloidosis (CA) is a rare health condition that occurs due to amyloid deposits in the heart's tissues, it causes restrictive cardiomy-opathy, which leads to heart failure and death. This report discusses a case of 72-year-old Saudi male known case of hypertension, diabetes mullets, left ventricular dysfunction, and chronic kidney dysfunction presented to hospital with shortness of breath, paroxysmal nocturnal dyspnea, and orthopnea. Patient's physical examination revealed jugular vein distention, generalized pitting edema and abdominal distension. Echo image exhibited abnormal myocardial texture with moderate global hypokinesia, left ventricular D shape, and thickened interatrial sep-tum. CA diagnosis is complex, and its diagnostic accuracy is relatively limited. Delay in CA diagnosis continues to challenge clinicians, which has adverse effects on patient's quality of life, and mortality rate. Underdiagnosis mainly because disease has nonspecific symptoms which often associated with poor prognosis. To aid in early diagnosis and treatment, nurses should be aware about symptoms, diagnostic approach, and disease progression of CA.

  • References

    1. Agibetov, A., Seirer, B., Dachs, T., Koschutnik, M., Dalos, D., Rettl, R., Duca, F., Schrutka, L., Agis, H., Kain, R., Auer-Grumbach, M., Binder, C., Mascherbauer, J., Hengstenberg, C., Samwald, M., Dorffner, G., & Bonderman, D. (2020). Machine learning enables prediction of cardiac amy-loidosis by routine laboratory parameters: A proof-of-concept study. Journal Of Clinical Medicine, 9(5), 1-11.
    2. Banypersad, S., Moon, J., Whelan, C., Hawkins, P., & Wechalekar, A. (2012). Updates in cardiac amyloidosis: A review. Journal Of The American Heart Association, 1(2), 1-10.
    3. Bhogal, S., Ladia, V., Sitwala, P., Cook, E., Bajaj, K., Ramu, V., & Paul, T. K. (2018). Cardiac amyloidosis: an updated review with emphasis on diagnosis and future directions. Current Problems in Cardiology, 43(1), 10-34.‏
    4. Cannon, J. D., Pullen, R. L., & Rushing, J. D. (2004). Managing the patient with amyloidosis. Dermatology Nursing, 16(3), 225.‏
    5. Comenzo, R. L., & Gertz, M. A. (2002). Autologous stem cell transplantation for primary systemic amyloidosis. Blood, 99(12), 4276-4282.‏
    6. Cornwell III, G. G., Murdoch, W. L., Kyle, R. A., Westermark, P., & Pitkänen, P. (1983). Frequency and distribution of senile cardiovascular amy-loid: a clinicopathologic correlation. The American Journal of Medicine, 75(4), 618-623
    7. Donnelly, J. P., & Hanna, M. (2017). Cardiac amyloidosis: An update on diagnosis and treatment. Cleveland Clinic Journal of Medicine, 84(12 Suppl 3), 12-26.‏
    8. Edwardson, S. R. (2007). Patient education in heart failure. Heart & Lung, 36(4), 244-252.‏
    9. Fine, N. M., Davis, M. K., Anderson, K., Delgado, D. H., Giraldeau, G., Kitchlu, A., & Zieroth, S. (2020). Canadian cardiovascular socie-ty/Canadian heart failure society joint position statement on the evaluation and management of patients with cardiac amyloidosis. Canadian Jour-nal of Cardiology, 36(3), 322-334.‏
    10. Gao, M., Liu, Q., & Chen, L. (2019). Cardiac amyloidosis as a rare cause of heart failure: A case report. Medicine, 98(14).‏
    11. Gertz, M. A., Comenzo, R., Falk, R. H., Fermand, J. P., Hazenberg, B. P., Hawkins, P. N., Merlini, G., Moreau, P., Ronco, P., Sanchorawala, V., Sezer, O., Solomon, A., & Grateau, G. (2005). Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis. American Journal Of Hematology, 79(4), 320-324.
    12. Gillmore, J. D., Maurer, M. S., Falk, R. H., Merlini, G., Damy, T., Dispenzieri, A., & Hawkins, P. N. (2016). Nonbiopsy diagnosis of cardiac trans-thyretin amyloidosis. Circulation, 133(24), 2404-2412.‏
    13. Halwani, O., & Delgado, D. H. (2010). Cardiac amyloidosis: an approach to diagnosis and management. Expert Review of Cardiovascular Therapy, 8(7), 1007-1013
    14. Kendall, H. (2010). Cardiac amyloidosis. Critical care nurse, 30(2), 16-23.
    15. ‏Klein, A. L., Hatle, L. K., Taliercio, C., Oh, J. K., Kyle, R. A., Gertz, M. A., & Tajik, A. J. (1991). Prognostic significance of doppler measures of diastolic function in cardiac amyloidosis. A doppler echocardiography study. Circulation, 83(3), 808-816.‏
    16. Mircsof, D. (2020). Diagnosis of amyloidosis: A survey of current awareness and clinical challenges among cardiologists in Switzerland. Cardiology and Therapy, 1-12.‏
    17. Mohammed, S. F., Mirzoyev, S. A., Edwards, W. D., Dogan, A., Grogan, D. R., Dunlay, S. M., Roger, V. L., Gertz, M. A., Dispenzieri, A., Zeldenrust, S. R., & Redfield, M. M. (2014). Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction. JACC: Heart Failure, 2(2), 113-122.‏
    18. Mueller, P. S., Edwards, W. D., & Gertz, M. A. (2000). Symptomatic ischemic heart disease resulting from obstructive intramural coronary amy-loidosis. The American Journal of Medicine, 109(3), 181-188. ‏
    19. Noordzij, W., Glaudemans, A. W., Longhi, S., Slart, R. H., Lorenzini, M., Hazenberg, B. P., & Rapezzi, C. (2015). Nuclear imaging for cardiac amyloidosis. Heart Failure Reviews, 20(2), 145-154.‏
    20. Picken, M. M. (2007). New insights into systemic amyloidosis: The importance of diagnosis of specific type. Current Opinion in Nephrology and Hypertension, 16(3), 196-203.‏
    21. Qian, G., Wu, C., Zhang, Y., Chen, Y. D., Dong, W., & Ren, Y. H. (2014). Prognostic value of high-sensitivity cardiac troponin T in patients with endomyocardial-biopsy proven cardiac amyloidosis. Journal of Geriatric Cardiology: JGC, 11(2), 136.‏
    22. Quarta, C. C., Solomon, S. D., Uraizee, I., Kruger, J., Longhi, S., Ferlito, M., & Falk, R. H. (2014). Left ventricular structure and function in trans-thyretin-related versus light-chain cardiac amyloidosis. Circulation, 129(18), 1840-1849.‏
    23. Ruberg, F. L., Maurer, M. S., Judge, D. P., Zeldenrust, S., Skinner, M., Kim, A. Y., Falk, R. H., Cheung, K. N., Patel, A. R., Pano, A., Packman, J., & Grogan, D. R. (2012). Prospective evaluation of the morbidity and mortality of wild-type and V122I mutant transthyretin amyloid cardiomyopa-thy: The transthyretin amyloidosis cardiac study (TRACS). American Heart Journal, 164(2), 222-228
    24. Selvanayagam, J. B., Hawkins, P. N., Paul, B., Myerson, S. G., & Neubauer, S. (2007). Evaluation and management of the cardiac amyloidosis. Journal of the American College of Cardiology, 50(22), 2101-2110.
    25. Shah, K. B., Inoue, Y., & Mehra, M. R. (2006). Amyloidosis and the heart: a comprehensive review. Archives of Internal Medicine, 166(17), 1805-1813.‏
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  • How to Cite

    Eid Al shammari, N. (2022). Nursing role in early detection of cardiac amyloidosis: a case report. International Journal of Advanced Nursing Studies, 11(1), 1-7.