heart failure caused by restrictive cardiomyopathy. role of integrated diagnostics for the etiologic...
TRANSCRIPT
Heart failure caused by restrictive cardiomyopathy. Role of integrated
diagnostics for the etiologic diagnosis
Dott. Cosimo CommissoU.O.C. Cardiologia – UTICPoliclinico Casilino , Rome - Italy
Disclosure
I have no actual or potential conflict of interest in relation to this
presentation
Clinic case
Woman, 43 years oldDiabetes mellitus Repeated hospitalizations for congestive
heart failure, on one occasion complicated by cardiac arrest
Previous diagnosis of myopathy with EMGCame to our attention for recurrent heart
failure complicated by state anasarcatico
Diagnosis of myopathy with EMG
Blood testsThrombocytopeniaHyperbilirubinemia (previous diagnosis of Gilbert's
syndrome )Proteinuria
ELECTROCARDIOGRAMBAV I°- Low voltage QRS
MONITORING ECG-graph repeated episodes of NSVT
BAV I°- Low voltage QRS
ECHOCARDIOGRAM
CARDIAC MRI with contrast medium
MORE CLINICAL INVESTIGATIONS
LABORATORY TESTSØ CK-MB negative
Ø Immunofixation SERUM and URINE Negative
LET'S PUT ALL TOGETHER...● Restrictive Syndrome
• Restrictive Syndrome • AV conduction disturbance• Signs of myopathy with EMG
ENDOMYOCARDIAL BIOPSY
AND NOW?