Figure 1. The electrocardiogram showed low voltage in the limb leads and a small R wave amplitude across the precordial leads (arrows).
Figure 2. The septal and free walls of the left ventricle were mildly thickened, and the left ventricular cavity dimension was enlarged. Doppler analysis of transmitral inflow showed restrictive pattern with high E/A ratio (2.3) (arrowheads). Tissue Doppler of mitral annular diastolic velocity (E’) was markedly reduced (2 cm/s) (arrows).
Figure 3. Repeated coronary angiography did not show any significant stenosis of the coronary arteries (arrows).
Figure 4. The gross finding showed that deposition of pale staining amorphous material in blood vessel and interstitium with degenerated myofibers (A) and microscopic findings stained with hematoxylin and eosin revealed myxoid and amorphous deposits in perivascular and interstitial spaces (B, arrowheads).
Figure 5. Congo-red stain of the specimen revealed apple green birefringence under polarized microscopy.