title: A Case of Cardiac Amyloidosis Presenting with Mid- to Late Diastolic Retrograde Flow from the Left Atrium to the Pulmonary Vein: Transesophageal Pulsed Doppler Echocardiographic Observations.
abstract: A patient of cardiac amyloidosis was found to have mid- to late diastolic retrograde flow from the left atrium (LA) to the pulmonary vein. Congo-red staining was positive for amyloid in the rectal tissue. M-mode and two-dimensional echocardiograms revealed symmetric hypertrophy and typical speckled pattern of the left ventricle (LV). The LV pressure curve showed a dip and plateau configuration during diastole, and end-diastolic pressure was 28 mmHg. In addition, the LV pressure was high at mid-diastole, surpassing the pulmonary capillary wedge pressure from mid- to late diastole. The transmitral flow velocity revealed "restrictive" pattern, and the pulmonary venous flow velocity showed retrograde flow from the LA to the pulmonary vein during mid-diastole and atrial systole. It is suggested that recording of the pulmonary venous flow velocity by transesophageal pulsed Doppler echocardiography is useful for understanding the mechanism of the development of pulmonary congestion or edema. (ECHOCARDIOGRAPHY, Volume 13, November 1996)
authors.affiliation: The Second Department of Internal Medicine, Tokushima University School of Medicine, 2-50 Kuramotocho, Tokushima 770, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Fukuda
authors.forename: Arata
authors.initials: A
authors.lastname: Iuchi
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Tabata
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Manabe
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Kageji
authors.forename: Miwa
authors.initials: M
authors.lastname: Sasaki
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamada
authors.forename: Susumu
authors.initials: S
authors.lastname: Ito