Thromboembolic Risk in Sinus Rhythm: A New Paradigm in Light Chain Cardiac Amyloidosis

: Thromboembolic risk is increased in cardiac amyloidosis, and this goes beyond the occurrence of atrial fibrillation in these patients. A 56-year-old man was admitted to our hospital for a presyncopal episode. Clinical and instrumental findings led to a diagnosis of light chain cardiac amyloidosis. Hospitalization was complicated by ischemic stroke resulting from embolization of a left atrial thrombus, that occurred in sinus rhythm. This case highlights the importance of a new diagnostic strategy for thromboembolic risk stratification in patients with cardiac amyloidosis. Left atrial strain assessment should be implemented in patients with cardiac amyloidosis to predict the occurrence of thromboembolic events.