Cardiac Amyloidosis Presenting as Congestive Heart Failure: A Case Report and Literature Review

Amyloidosis is a systemic disease characterized by extracellular infiltration of amyloid fibrils. Cardiac involvement, marked by nonspecific clinical signs, significantly influences prognosis. Initially considered rare, this involvement is increasingly diagnosed through imaging techniques, including magnetic resonance imaging (MRI), which allows for improved characterization of myocardial tissue. We present the case of a 61-year-old patient who exhibited congestive heart failure attributed to cardiac amyloidosis. The diagnosis was suspected due to concentric left ventricular hypertrophy (LVH), myocardial sparkling appearance, and concentric coiled pattern in global longitudinal strain, as revealed in imaging. MRI strengthened the sensitivity of transthoracic echocardiography by identifying myocardial infiltration. Bone scintigraphy showed no signs of increased bone uptake. The biochemical assessment supported the presence of monoclonal gammopathy.