Question
A 65-year-old female with congestive heart failure (CHF) presents to the emergency department with complaints of dyspnea, fatigue, and bilateral lower leg edema. She was diagnosed with CHF three years ago. Her symptoms have increased in severity and are progressive. She also complains of joint pains. Her electrocardiogram (ECG) reveals low voltage QRS complexes. An echocardiogram reveals markedly increased left ventricle wall thickness, thickening of the mitral and tricuspid leaflets, and restrictive filling. Cardiac catheterization shows the absence of coronary artery disease. An endomyocardial biopsy is done, which shows myocardial replacement with acellular eosinophilic material. The material shows apple-green birefringence on congo red staining. What is this material?
| A. |
Monosodium urate crystals |
| B. |
Iron deposits |
| C. |
Calcium pyrophosphate crystals |
| D. |
Calcium pyrophosphate crystals |
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