LQCL2401 - CMLE - An Unusual Cause of Syncope-An Unusual Cause of Syncope

An Unusual Cause of Syncope

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The document discusses a case of an 80-year-old man presenting with syncope and the subsequent evaluation revealing elevated cardiac biomarkers, including troponin, NT-proBNP, and abnormal free light chain (FLC) ratio indicating possible cardiac amyloidosis. The patient had a history of coronary artery disease, heart block, and pacemaker placement. Despite ruling out myocardial infarction, cardiac amyloidosis was suspected due to abnormal strain pattern on echo and elevated FLC ratio. The diagnosis was confirmed with an endomyocardial biopsy. Treatment with daratumumab and CyBorD regimen was initiated for stage IV AL amyloidosis. The document also highlights the importance of various tests like natriuretic peptides, troponin, and FLCs in diagnosing and staging cardiac amyloidosis. Additionally, it addresses the challenges and considerations for laboratory tests, analytic cutoffs, and staging criteria for AL amyloidosis, emphasizing the multidisciplinary nature of the diagnosis and monitoring of cardiac amyloidosis. Further details include the definition and causes of syncope, criteria for myocardial infarction, and differentiation between various plasma cell dyscrasias along with references for in-depth information on the topic.

Keywords

syncope

cardiac biomarkers

troponin

NT-proBNP

free light chain ratio

cardiac amyloidosis

coronary artery disease

endomyocardial biopsy

AL amyloidosis

natriuretic peptides