AL amyloidosis masquerading as cardiac syncope: a case report

Abstract

Amyloidosis is a systemic illness due to the deposition of proteins resistant to proteolysis digestion. It is manifested by the primary causes of amyloidosis like hematological malignancy or chronic inflammatory process, and the organs where’s the proteins deposited. AL-Amyloidosis is secondary to monoclonal plasma cell expansion, where the light or heavy chains of the immunoglobulins deposited in specific organs like the heart, the kidneys, the gastrointestinal tract, or the nervous system. Cardiac manifestations are commonly heart failure and conduction defects causing variable arrhythmia and syncope. Gastrointestinal manifestations are variable, but common presentations are recurrent vomiting, hepatomegaly, and gastrointestinal bleeding. In this report, we present a case of amyloidosis presented with syncope that was missed to be due to amyloidosis and presented later with heart failure and an incidental recto-sigmoid amyloid polyp. Additionally, we review the relevant literature to raise awareness about this entity.