Amiodarone deposition in the liver

Case contributed by Ammar Ashraf
Diagnosis almost certain

Presentation

Chest pain and shortness of breath. No fever.

Patient Data

Age: 75 years
Gender: Female

Increased hepatic attenuation (average density=91 HU). Mild cardiomegaly. Multiple calcifications are seen in the coronary arteries. Mild bronchiectatic and atelectatic changes in the right middle lobe. No pleural/pericardial effusion or significant mediastinal lymphadenopathy is seen. Small fat containing right posterior diaphragmatic hernia. Small isodense cortical lesion/cyst at the upper pole of the left kidney.

Annotated image

Annotated CT image showing the density measurement (HU) of the liver and spleen.

24-hour holter monitor

Photo

24-hour holter monitor report showing multiple premature ventricular contractions (PVCs).

Case Discussion

  • Known case of bronchial asthma, hypertension and heart failure.

  • Patient is on amiodarone for last three years for high premature ventricular contractions (PVCs) burden.

  • Echocardiogram: Ejection fraction =45-50 %, moderate-severe mitral regurgitation, mild-moderate aortic regurgitation, mild tricuspid regurgitation, grade 1 diastolic dysfunction, normal IVC and pericardium.

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