Case Report: A missed diagnosis of cardiac amyloidosis using echocardiography due to immunoglobulin light chain amyloidosis with normal wall thickness in the early stage

Patients presenting with normal wall thickness in a non-dilated LV might only be in an early stage of CA. Thus, the diagnosis can be easily overlooked. For smaller individuals, relative wall thickness (RWT) may be a more sensitive indicator for further investigation. In patients presenting with increased RWT, restrictive filling, and pericardial effusion in the absence of other plausible causes, CA should be considered, even in the absence of the classic echocardiographic signs of amyloid deposition. Furthermore, two-dimensional speckle-tracking echocardiography can enhance clinical suspicion of CA and should be recommended as part of the diagnostic workup.