Slip-Ups in the Diagnosis of Cardiac Amyloidosis: A Case Fatality in Point

This case report illustrates a tragic example of a "missed diagnosis" of amyloid light-chain (AL) amyloidosis with cardiac involvement that led to progressive heart failure and the ultimate death of the patient. It had a rather atypical presentation in terms of cardiac imaging, although there were certain highly suspicious clinical features, cardiac and otherwise. It also illustrates the importance of selecting the most appropriate assays to establish (or rule out) the presence of monoclonal immunoglobulin consistent with AL amyloidosis, which has a poor clinical prognosis, as unfortunately demonstrated in this case.