CTICasesCardiac Amyloidosis with Left Atrial Dominance
Imaging findings
Cardiac MRI shows pronounced, asymmetric thickening of the left atrial wall accompanied by severe hypo-contractility of the chamber. Late gadolinium enhancement imaging demonstrates intense, diffuse enhancement of the entire left atrial wall with only minimal, localized septal left ventricular involvement.
Key takeaways
While cardiac amyloidosis classically manifests as restrictive cardiomyopathy with bi-ventricular thickening and diffuse subendocardial late gadolinium enhancement, atypical presentations can occur. Isolated or predominant atrial amyloidosis can present with severe atrial thickening, profound hypokinesia, and intense enhancement, mimicking a neoplastic process or atrial scarring.
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