An 82-year-old man arrives to the office because he has been experiencing increased dyspnea and weariness for the past year, which has limited his daily activities. He has also experienced bilateral foot edema. Amlodipine is used to treat the patient's hypertension. His blood pressure is 122/72 mm Hg, and his pulse rate is 55 beats per minute. Physical examination demonstrates high jugular venous pressure, a fast 'y' decline, and a pronounced S4. An abdominal exam reveals moderate ascites. The patient has 3+ bilateral pitting edema of the lower extremities. The echocardiogram shows left atrial enlargement, as well as significant left ventricular hypertrophy and a normal left ventricular ejection percentage. The complete blood count and basic metabolic panel are normal. The results of an endomyocardial biopsy are displayed below. Which of the following is the most likely diagnosis?

Question

An 82-year-old man arrives to the office because he has been experiencing increased dyspnea and weariness for the past year, which has limited his daily activities. He has also experienced bilateral foot edema. Amlodipine is used to treat the patient's hypertension. His blood pressure is 122/72 mm Hg, and his pulse rate is 55 beats per minute. Physical examination demonstrates high jugular venous pressure, a fast 'y' decline, and a pronounced S4. An abdominal exam reveals moderate ascites. The patient has 3+ bilateral pitting edema of the lower extremities. The echocardiogram shows left atrial enlargement, as well as significant left ventricular hypertrophy and a normal left ventricular ejection percentage. The complete blood count and basic metabolic panel are normal. The results of an endomyocardial biopsy are displayed below.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Infiltrative illnesses (such as amyloidosis, sarcoidosis, and hemochromatosis) can induce restrictive cardiomyopathy, which frequently culminates in diastolic heart failure due to ventricular hypertrophy and decreased ventricular filling. Histologically, cardiac amyloidosis is distinguished by regions of myocardium invaded by an amorphous and acellular pink substance (amyloid).

An 82-Year-Old Man Arrives to the Office Because He Has