quarta-feira, maio 12, 2010
Doença de depósito
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Provável Amiloidose.
"espessamento da parede ventricular, granulações ao nível de ventrículo
direito, hipocinesia importante e derrame pericárdico não muito volumoso, espessamento das valvas e septo interatrial."
Em paciente com história de emagrecimento de 15 kg nos últimos 4 meses e anemia.
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AMILOIDOSE?PODES COMENTAR?
ResponderExcluirInfiltrative cardiomyopathies are characterized by the deposition of abnormal substances that cause the ventricular
ResponderExcluirwalls to become progressively rigid, thereby impeding ventricular filling. Some infiltrative cardiac diseases
increase ventricular wall thickness, while others cause chamber enlargement with secondary wall thinning. Increased
wall thickness, small ventricular volume, and occasional dynamic left ventricular outflow obstruction
(e.g., amyloidosis) can outwardly appear similar to conditions with true myocyte hypertrophy (e.g., hypertrophic
cardiomyopathy, hypertensive heart disease). Likewise, infiltrative disease that presents with a dilated left ventricle
with global or regional wall motion abnormalities and aneurysm formation (e.g., sarcoidosis) may mimic
ischemic cardiomyopathy. Low-voltage QRS complex was the sine qua non of infiltrative cardiomyopathy (i.e.,
cardiac amyloid). However, low-voltage QRS complex is not a uniform finding with the infiltrative cardiomyopathies.
The clinical presentation, along with functional and morphologic features, often provides enough insight to
establish a working diagnosis. In most circumstances, however, tissue or serologic evaluation is needed to validate
or clarify the cardiac diagnosis and institute appropriate therapy. (J Am Coll Cardiol 2010;55:1769–79)