Heart Failure: As Initial Presentation of Systemic Amyloidosis in Absence of Renal Features

Amyloidosis is the term for a group of protein folding disorders characterized by the extracellular deposition of insoluble polymeric protein fibrils in tissues and organs. Systemic amyloidosis can have variable clinical presentation. Heart is the 2nd most commonly affected organ (50-60 % cases), after renal involvement. But cardiac involvement as initial presentation is rare. Amyloid cardiomyopathy is characterized by concentric ventricular hypertrophy and diastolic dysfunction associated with elevation of brain natriuretic peptide and troponin.