04 July 2025
: Case report 
Navigating Diagnostic Ambiguities in Cardiac Amyloidosis: Insights from a Case with Delayed Diagnosis of AL Amyloidosis
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Educational Purpose (only if useful for a systematic review or synthesis)
Antonio Al Hazzouri ADEF 1, Rose-Mary Daou
ADEF 1, Philippe Attieh ADEF 1, Zahi Ibrahim ADEF 1, Hilda E. Ghadieh EG 1, Bernard Harbieh ADEF 1*
DOI: 10.12659/AJCR.948092
Am J Case Rep 2025; 26:e948092
Table 1 Summary of the chronological order of the clinical progression of the patient along with the corresponding workup and management.
| Time | Symptoms | Workup + Management |
|---|---|---|
| Prior to presentation | Dyspnea of several months’ duration with recent sporadic dry cough, no CHF-LIKE symptoms, and no orthopnea nor paroxysmal nocturnal dyspnea | |
| 1 month later | No improvement of symptoms | |
| At presentation | Same symptoms | |
| 4 months later | He had a stroke related to paroxysmal atrial fibrillation and clinical deterioration characterized by borderline blood pressure, lower-limb edema, pleural effusion, and ascites, which were refractory to oral diuresis | |
| 6 months after presentation and admission for IV diuretics | No improvement in symptoms |