{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:33:06Z","timestamp":1765233186213,"version":"3.41.2"},"reference-count":38,"publisher":"IMR Press","issue":"3","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Amyloid light-chain (AL) amyloidosis is a multisystemic disease. Among its clinical manifestations, vein and arterial thromboembolic events are included. We report the unusual case of a 57-year-old female patient with AL amyloidosis presenting with an ST segment elevation myocardial infarction due to coronary artery embolization (CE). The patient reported a history of exertional dyspnoea along with episodes of haemoptysis for the last few months. Her coronary angiography demonstrated embolization of the distal segment of the left anterior descending artery. The main findings of her cardiac ultrasound included concentric left ventricular hypertrophy, mildly impaired left ventricular systolic function, left atrium enlargement and a restrictive-like filling pattern, while her chest computed tomography (CT) demonstrated bilateral pleural effusions. Cardiac magnetic resonance imaging that was performed afterwards, indicated areas of microvascular infarction, a small apex infarct and findings compatible with possible amyloidosis, a diagnosis that was confirmed later by fat tissue biopsy. Patient was referred for an oncology consultation, started therapy with direct oral anticoagulants, angiotensin converting enzyme inhibitor, statins and anti-plasma cell therapy. She has been improving since then and has been free of cardiovascular events for a follow-up period of 12 months. Cardiologists ought to be aware of amyloidosis as a rare but possible cause of coronary embolization, while close collaboration with oncologists is required for the establishment of the correct diagnosis.<\/jats:p>","DOI":"10.31083\/j.rcm2203094","type":"journal-article","created":{"date-parts":[[2021,9,26]],"date-time":"2021-09-26T02:35:45Z","timestamp":1632623745000},"source":"Crossref","is-referenced-by-count":1,"title":["Cardiac amyloidosis presenting with coronary artery embolization"],"prefix":"10.31083","volume":"22","author":[{"given":"Christos","family":"Papageorgiou","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleftheria","family":"Tsagalou","sequence":"first","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Baraboutis","sequence":"first","affiliation":[{"name":"Internal Medicine Clinic, Pammakaristos Hospital of Divine Providence, 11144 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Tampakis","sequence":"first","affiliation":[{"name":"First Cardiac Department, Henry Dunant Hospital Center, 11526 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstathios","family":"Kastritis","sequence":"first","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meletios-Athanasios","family":"Dimopoulos","sequence":"first","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Shibata T, Kawakami S, Noguchi T, Tanaka T, Asaumi Y, Kanaya T, et al. Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism. Circulation. 2015; 132: 241\u2013250.","DOI":"10.1161\/CIRCULATIONAHA.114.015134"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Popovic B, Agrinier N, Bouchahda N, Pinelli S, Maigrat CH, Metzdorf PA, et al. Coronary Embolism among ST-Segment-Elevation Myocardial Infarction Patients: Mechanisms and Management. Circulation Cardiovascular Interventions. 2018; 11: e005587.","DOI":"10.1161\/CIRCINTERVENTIONS.117.005587"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Hern\u00e1ndez F, Pombo M, Dalmau R, Andreu J, Alonso M, Albarr\u00e1n A, et al. Acute coronary embolism: angiographic diagnosis and treatment with primary angioplasty. Catheterization and Cardiovascular Interventions. 2002; 55: 491\u2013494.","DOI":"10.1002\/ccd.10122"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction. Circulation. 2018; 138: e618\u2013e651.","DOI":"10.1161\/CIR.0000000000000617"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Parviz Y, Shlofmitz E, Fall KN, Konigstein M, Maehara A, Jeremias A, et al. Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography. British Medical Bulletin. 2018; 125: 79\u201390.","DOI":"10.1093\/bmb\/ldx049"},{"key":"ref6","unstructured":"Rathod KS, Hamshere SM, Jones DA, Mathur A. Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging \u2013 Apples and Oranges? Interventional Cardiology. 2015; 10: 8\u201315."},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Tamis-Holland JE, Jneid H, Reynolds HR, Agewall S, Brilakis ES, Brown TM, et al. 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. Circulation. 2019; 139: e891\u2013e908.","DOI":"10.1161\/CIR.0000000000000670"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Gatti M, Carisio A, D\u2019Angelo T, Darvizeh F, Dell\u2019Aversana S, Tore D, et al. Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries patients: a review. World Journal of Cardiology. 2020; 12: 248\u2013261.","DOI":"10.4330\/wjc.v12.i6.248"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Violi F, Soliman EZ, Pignatelli P, Pastori D. Atrial Fibrillation and Myocardial Infarction: a Systematic Review and Appraisal of Pathophysiologic Mechanisms. Journal of the American Heart Association. 2016; 5: e003347.","DOI":"10.1161\/JAHA.116.003347"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Raphael CE, Heit JA, Reeder GS, Bois MC, Maleszewski JJ, Tilbury RT, et al. Coronary Embolus: an Underappreciated Cause of Acute Coronary Syndromes. JACC. Cardiovascular Interventions. 2018; 11: 172\u2013180.","DOI":"10.1016\/j.jcin.2017.08.057"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. 2015; 28: 1\u201339.e14.","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Chatzantonis G, Bietenbeck M, Elsanhoury A, Tsch\u00f6pe C, Pieske B, Tauscher G, et al. Diagnostic value of cardiovascular magnetic resonance in comparison to endomyocardial biopsy in cardiac amyloidosis: a multi-centre study. Clinical Research in Cardiology. 2021; 110: 555\u2013568.","DOI":"10.1007\/s00392-020-01771-1"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Garcia-Pavia P, Rapezzi C, Adler Y, Arad M, Basso C, Brucato A, et al. Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases. European Heart Journal. 2021; 42: 1554\u20131568.","DOI":"10.1093\/eurheartj\/ehab072"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Guan J, Mishra S, Falk RH, Liao R. Current perspectives on cardiac amyloidosis. American Journal of Physiology-Heart and Circulatory Physiology. 2012; 302: H544\u2013H552.","DOI":"10.1152\/ajpheart.00815.2011"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Muchtar E, Dispenzieri A, Magen H, Grogan M, Mauermann M, McPhail ED, et al. Systemic amyloidosis from a (AA) to T (ATTR): a review. Journal of Internal Medicine. 2021; 289: 268\u2013292.","DOI":"10.1111\/joim.13169"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Wechalekar AD, Gillmore JD, Hawkins PN. Systemic amyloidosis. Lancet. 2016; 387: 2641\u20132654.","DOI":"10.1016\/S0140-6736(15)01274-X"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Yilmaz A, Sechtem U. Diagnostic approach and differential diagnosis in patients with hypertrophied left ventricles. Heart. 2014; 100: 662\u2013671.","DOI":"10.1136\/heartjnl-2011-301528"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Feng D, Edwards WD, Oh JK, Chandrasekaran K, Grogan M, Martinez MW, et al. Intracardiac thrombosis and embolism in patients with cardiac amyloidosis. Circulation. 2007; 116: 2420\u20132426.","DOI":"10.1161\/CIRCULATIONAHA.107.697763"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Ritts AJ, Cornell RF, Swiger K, Singh J, Goodman S, Lenihan DJ. Current Concepts of Cardiac Amyloidosis: Diagnosis, Clinical Management, and the need for Collaboration. Heart Failure Clinics. 2017; 13: 409\u2013416.","DOI":"10.1016\/j.hfc.2016.12.003"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Mankad AK, Sesay I, Shah KB. Light-chain cardiac amyloidosis. Current Problems in Cancer. 2017; 41: 144\u2013156.","DOI":"10.1016\/j.currproblcancer.2016.11.004"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Kumar S, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, Colby C, et al. Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements. Journal of Clinical Oncology. 2012; 30: 989\u2013995.","DOI":"10.1200\/JCO.2011.38.5724"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Park H, Kim J, Youk J, Koh Y, Lee J, Kim KH, et al. Serum Free Light Chain Difference and \u03b22 Microglobulin Levels are Risk Factors for Thromboembolic Events in Patients with AL Amyloidosis. Clinical Lymphoma, Myeloma & Leukemia. 2018; 18: 408\u2013414.","DOI":"10.1016\/j.clml.2018.03.005"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Cappelli F, Padeletti L, Acquafresca M, Pignone AM, Perfetto F. Repeated systemic thromboembolism in a patient with severe cardiac AL amyloidosis without evidence of atrial fibrillation. Internal and Emergency Medicine. 2014; 9: 243\u2013245.","DOI":"10.1007\/s11739-013-0960-8"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Mihalek AD, Haney C, Merino M, Roy-Chowdhuri S, Moss J, Olivier KN. Exercise-induced haemoptysis as a rare presentation of a rare lung disease. Thorax. 2016; 71: 865\u2013868.","DOI":"10.1136\/thoraxjnl-2015-208020"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Van de Veire NR, Dierick J, De Sutter J. Intracardiac emboli as first presentation of cardiac AL amyloidosis. European Heart Journal. 2012; 33: 818.","DOI":"10.1093\/eurheartj\/ehr330"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Neben-Wittich MA, Wittich CM, Mueller PS, Larson DR, Gertz MA, Edwards WD. Obstructive intramural coronary amyloidosis and myocardial ischemia are common in primary amyloidosis. American Journal of Medicine. 2005; 118: 1287.","DOI":"10.1016\/j.amjmed.2005.06.017"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Nguyen HT, Nguyen CTH. Cardiac amyloidosis mimicking acute coronary syndrome: a case report and literature review. European Heart Journal - Case Reports. 2020; 4: 1\u20137.","DOI":"10.1093\/ehjcr\/ytaa325"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Hausfater P, Costedoat-Chalumeau N, Amoura Z, Cacoub P, Papo T, Grateau G, et al. AL cardiac amyloidosis and arterial thromboembolic events. Scandinavian Journal of Rheumatology. 2005; 34: 315\u2013319.","DOI":"10.1080\/03009740510015203"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Cho K, Cho YM, Kim JS. Embolic infarction associated with cardiac amyloidosis. Journal of Clinical Neurology. 2005; 1: 92\u201396.","DOI":"10.3988\/jcn.2005.1.1.92"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Lahmidi I, Aissaoui H, Ismaili N, Elouafi N. Acute Coronary Artery Thrombosis in a Patient with Non-Small Cell Lung Cancer. Cureus. 2021; 13: e13538.","DOI":"10.7759\/cureus.12507"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Yuksel M, Yildiz A, Tapan U, Ertas F, Alan S. Resolution of Extensive Coronary Thrombosis under Rivaroxaban Treatment. Arquivos Brasileiros De Cardiologia. 2015; 105: 642\u2013646.","DOI":"10.5935\/abc.20150052"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Yan Q, Ning L, Jian Y, Yang W, Yuan Q, Du Z. Could the Novel Oral Anticoagulants be used for Coronary Artery Aneurysm? Case Reports in Medicine. 2020; 2020: 5073814.","DOI":"10.1155\/2020\/5073814"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Carrier M, Soff G, Le Gal G. Treatment of Venous Thromboembolism in Cancer. Historical Perspective and Evolving Role of the Direct Oral Anticoagulants. Cancer Treatment and Research. 2019; 179: 103\u2013115.","DOI":"10.1007\/978-3-030-20315-3_7"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Jones DA, Wright P, Alizadeh MA, Fhadil S, Rathod KS, Guttmann O, et al. The Use of Novel Oral Anti-Coagulant\u2019s (NOAC) compared to Vitamin K Antagonists (Warfarin) in patients with Left Ventricular thrombus after Acute Myocardial Infarction (AMI). European Heart Journal\u2014Cardiovascular Pharmacotherapy. 2020: pvaa096.","DOI":"10.1093\/ehjcvp\/pvaa096"},{"key":"ref35","unstructured":"Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing G, Harjola V, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). European Respiratory Journal. 2020; 41: 543\u2013603."},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Clay RD, Utz JP. Coital Hemoptysis Due to Cardiac AL Amyloidosis. Mayo Clinic Proceedings. 2018; 93: 811\u2013812.","DOI":"10.1016\/j.mayocp.2018.04.016"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Palladini G, Campana C, Klersy C, Balduini A, Vadacca G, Perfetti V, et al. Serum N-terminal pro-brain natriuretic peptide is a sensitive marker of myocardial dysfunction in AL amyloidosis. Circulation. 2003; 107: 2440\u20132445.","DOI":"10.1161\/01.CIR.0000068314.02595.B2"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Maleszewski JJ. Cardiac amyloidosis: pathology, nomenclature, and typing. Cardiovascular Pathology. 2015; 24: 343\u2013350.","DOI":"10.1016\/j.carpath.2015.07.008"}],"container-title":["Reviews in Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/22\/3\/10.31083\/j.rcm2203094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T17:33:49Z","timestamp":1732728829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/22\/3\/10.31083\/j.rcm2203094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,24]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"alternative-id":["1632453084984-829991889"],"URL":"https:\/\/doi.org\/10.31083\/j.rcm2203094","relation":{},"ISSN":["1530-6550","2153-8174"],"issn-type":[{"type":"print","value":"1530-6550"},{"type":"electronic","value":"2153-8174"}],"subject":[],"published":{"date-parts":[[2021,9,24]]},"article-number":"883"}}