Cardiac involvement in myeloma-associated systemic amyloidosis

Abstract

Three cases of myeloma-associated amyloidosis presenting with cardiac failure are reported. Two cases expired within few weeks of initiation of melphalan and prednisolone chemotherapy. Cause of deaths were intractable heart failure and undetermined in a patient. It is concluded that systemic AL amyloidosis must be considered in the differential diagnosis of heart failure among middle-aged and elderly patients in the absence of coronary artery disease. Transthoracic echocardiogram has been shown to be a useful tool in diagnosing amyloid cardiomyopathy. The presence of plasma cell dyscrasia and the extent of organ involvement are important to determine the prognosis and the response to therapy.