Abstract
There are more than a few risks of hemorrhage complication in patients with amyloidosis. Although most cases with amyloidosis exhibit minor bleeding manifestations, they can be occasionally associated with life-threatening problems. To our knowledge, there are only a few cases of spontaneous pericardial hematoma associated with amyloidosis. We here report a patient who suddenly died of cardiac tamponade with massive pericardial hematoma 7 years after the diagnosis of familial amyloid polyneuropathy (FAP). A 69-year-old female with FAP with cardiogenic shock was admitted to our emergency room. Although she previously underwent permanent pacemaker implantation for atrial fibrillation with slow ventricular response, electrocardiogram showed a critical pacing failure. Emergent telemetry check revealed a sudden extreme increase of pacing capture threshold in the right ventricle. Maximum pacing voltage could not improve the critical condition, and she died 7 h after arrival. Autopsy showed a massive pericardial hematoma in the right ventricular free wall, and microscopic examination revealed typical amyloid deposition in the arterial wall of the pericardium. In this case, it is assumed that a sudden rupture of fragile pericardial ves...Continue Reading
References
Jan 1, 1977·American Journal of Hematology·R A McPhersonP L Wolf
Mar 11, 1983·JAMA : the Journal of the American Medical Association·R A YoodA S Cohen
Dec 1, 1994·Clinical and Laboratory Haematology·M RapoportA Kornberg
Nov 1, 1993·Internal Medicine·Y HoshinoY Miura
Sep 1, 1996·The Journal of Trauma·D L Brown, T D Ivey
Apr 16, 1998·The Journal of Thoracic and Cardiovascular Surgery·A K KonstantakosJ H Lee
Jul 29, 1998·Circulation·C ZellnerN B Schiller
Aug 12, 1999·Pediatric Cardiology·D CordesE M Shaffer
Mar 10, 2001·Blood·E B ChoufaniD C Seldin
Jul 14, 2001·Pacing and Clinical Electrophysiology : PACE·I García-BolaoI Díaz-Dorronsoro
Jan 16, 2002·The Annals of Thoracic Surgery·K WatanabeL F Camilleri
Mar 18, 2003·Heart·P Velavan, A Chauhan
Aug 9, 2003·The New England Journal of Medicine·Giampaolo Merlini, Vittorio Bellotti
Mar 1, 2005·Pacing and Clinical Electrophysiology : PACE·Mohammed N KhanBruce L Wilkoff
Jul 13, 2005·Pacing and Clinical Electrophysiology : PACE·Ahmed SanoussiMarc Joris
Aug 4, 2005·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Per WestermarkUNKNOWN Nomenclature Committee of the International Society of Amyloidosis
Sep 21, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Srijoy MahapatraDavid L Hayes
May 30, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Christoph SuckerRuediger E Scharf
Jan 24, 2007·Pacing and Clinical Electrophysiology : PACE·David A HirschlLinda B Haramati
Apr 11, 2007·Circulation·Sunil SinghalMichael A Acker
Feb 13, 2008·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Serdar KahveciogluBerna Calisir
Sep 19, 2008·Journal of Cardiovascular Medicine·Riccardo IevaMatteo Di Biase