Thromboembolic Risk in Sinus Rhythm: A New Paradigm in Light Chain Cardiac Amyloidosis

Giulia Marchionni; Jacopo Costantino; Federico Ballatore; Maria Alfarano; Nicola Galea; Martina Leopizzi; Lucrezia Netti; Viviana Maestrini; Carmine Dario Vizza; Cristina Chimenti

doi:10.1016/j.jaccas.2024.102531

Thromboembolic Risk in Sinus Rhythm: A New Paradigm in Light Chain Cardiac Amyloidosis

JACC Case Rep. 2024 Sep 18;29(18):102531. doi: 10.1016/j.jaccas.2024.102531.

Affiliations

¹ University of Pavia, Pavia, Italy.
² Department of Clinical, Anesthesiological and Cardiovascular Sciences, I School of Medicine, Sapienza University of Rome, Rome, Italy.
³ Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
⁴ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.

Abstract

Thromboembolic risk is increased in cardiac amyloidosis, and this goes beyond the occurrence of atrial fibrillation in these patients. A 56-year-old man was admitted to our hospital for a presyncopal episode. Clinical and instrumental findings led to a diagnosis of light chain cardiac amyloidosis. Hospitalization was complicated by ischemic stroke resulting from embolization of a left atrial thrombus, that occurred in sinus rhythm. This case highlights the importance of a new diagnostic strategy for thromboembolic risk stratification in patients with cardiac amyloidosis. Left atrial strain assessment should be implemented in patients with cardiac amyloidosis to predict the occurrence of thromboembolic events.

Keywords: anticoagulation; atrial fibrillation; atrial strain; cardiac amyloidosis; stroke; thromboembolic risk.

Publication types

Case Reports