{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:08:38Z","timestamp":1779322118071,"version":"3.51.4"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac amyloidosis can present with troponin-positive chest pain and non-obstructive coronary arteries, mimicking acute coronary syndrome. When a concurrent treatable diagnosis, such as pericarditis, is identified, symptomatic improvement may lead to premature diagnostic closure and failure to pursue confirmatory testing for an underlying infiltrative cardiomyopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A man in his 70s presented with pleuritic chest pain and troponin-T of 1840\u2005ng\/L. Coronary angiography was normal. Echocardiography revealed left ventricular hypertrophy with apical sparing on longitudinal strain. Cardiac magnetic resonance showed diffuse subendocardial late gadolinium enhancement and elevated extracellular volume (48%). Positron emission tomography (18F-FDG-PET) confirmed active pericarditis but no myocardial inflammation. Endomyocardial biopsy confirmed amyloid deposits; 99mTechnetium pyrophosphate scintigraphy confirmed transthyretin amyloid (ATTR) cardiomyopathy. He was treated for myopericarditis and referred for ATTR therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights how symptomatic resolution after treatment of acute pericarditis can obscure a co-existing infiltrative cardiomyopathy, and why persistent imaging red flags, including apical sparing on strain, diffuse subendocardial late gadolinium enhancement, and markedly elevated extracellular volume, should prompt definitive testing regardless of clinical improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag310","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:08:19Z","timestamp":1777637299000},"source":"Crossref","is-referenced-by-count":0,"title":["Premature diagnostic closure after pericarditis treatment delays recognition of ATTR cardiomyopathy: a multimodality case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1454-0251","authenticated-orcid":false,"given":"Christopher J","family":"Kocx","sequence":"first","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital , Camperdown, Sydney, NSW 2050 ,","place":["Australia"]},{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney, NSW 2000 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Rolfe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital , Camperdown, Sydney, NSW 2050 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo-Dee","family":"Lattimore","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital , Camperdown, Sydney, NSW 2050 ,","place":["Australia"]},{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney, NSW 2000 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imre","family":"Hunyor","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital , Camperdown, Sydney, NSW 2050 ,","place":["Australia"]},{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney, NSW 2000 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"2026052019385568000_ytag310-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaccao.2023.12.006","article-title":"Cardiac troponin in patients with light chain and transthyretin cardiac amyloidosis: JACC: cardioOncology state-of-the-art review","volume":"6","author":"De Michieli","year":"2024","journal-title":"JACC CardioOncol"},{"key":"2026052019385568000_ytag310-B2","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.jacc.2022.11.022","article-title":"2023 ACC expert consensus decision pathway on comprehensive multidisciplinary care for the patient with cardiac amyloidosis: a report of the American College of Cardiology Solution Set Oversight Committee","volume":"81","author":"Kittleson","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"2026052019385568000_ytag310-B3","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1136\/heartjnl-2012-302353","article-title":"Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis","volume":"98","author":"Phelan","year":"2012","journal-title":"Heart"},{"key":"2026052019385568000_ytag310-B4","article-title":"ASNC\/AHA\/ASE\/EANM\/HFSA\/ISA\/SCMR\/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2-evidence base and standardized methods of imaging","volume":"14","author":"Dorbala","year":"2021","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026052019385568000_ytag310-B5","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1002\/ehf2.12518","article-title":"Transthyretin cardiac amyloidosis: an update on diagnosis and treatment","volume":"6","author":"Yamamoto","year":"2019","journal-title":"ESC Heart Fail"},{"key":"2026052019385568000_ytag310-B6","doi-asserted-by":"crossref","first-page":"e891","DOI":"10.1161\/CIR.0000000000000670","article-title":"Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American Heart Association","volume":"139","author":"Tamis-Holland","year":"2019","journal-title":"Circulation"},{"key":"2026052019385568000_ytag310-B7","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.119.006075","article-title":"Expert consensus recommendations for the suspicion and diagnosis of transthyretin cardiac amyloidosis","volume":"12","author":"Maurer","year":"2019","journal-title":"Circ Heart Fail"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag310\/68223813\/ytag310.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/5\/ytag310\/68223813\/ytag310.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/5\/ytag310\/68223813\/ytag310.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T23:39:03Z","timestamp":1779320343000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag310\/8670079"}},"subtitle":[],"editor":[{"given":"Abdelsalam","family":"Bensaaud","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Palmieri","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kitai","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag310","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,4,30]]},"article-number":"ytag310"}}