Amyloidosis: clinical pentad.

摘要

A 50-year-old woman with a history of carpal tunnel syndrome presented to our hospital with the new onset of symptomatic atrial fibrillation with a rapid ventricular response and congestive heart failure. On physical examination, she was an ill-looking woman with periorbital ecchymoses (Fig. la), macroglossia (Fig. 1b), elevated jugular venous pressure and hepatojugular reflux, crackles in the right lung base, ascites and bilateral lower extremity pitting oedema. Chest X-ray was consistent with congestive heart failure. An electrocardiogram (ECG) showed diffuse low-amplitude voltages and a pseudoinfarction pattern in the anteroseptal leads (Fig. 2a).