Echocardiography is considered as the first as well as the most important diagnostic approach to identify patients living with cardiac amyloidosis (CA). It is still not clear the evolution process of echocardiography during the development of CA, leaving it extremely difficult for clinicians to recognize patients who are suspected of CA at an early stage. Here, we report a patient in his seventies diagnosed with lymphoma-associated AL amyloidosis. The sequence of abnormal changes in echocardiography included decreased left ventricular diastolic function, pericardial effusion, left atrium expansion, ventricular septal thickening, left ventricular posterior wall thickening, right atrium expansion, and decreased cardiac function. A decrease in left ventricular diastolic function and pericardial effusion occurred 3 months prior to a thickening in interventricular septum. Once suspected, 2D-STE examination is highly recommended in the early diagnosis of CA.

Cardiac injury presents a great challenge to the emergency doctors because these injuries require urgent intervention to prevent death. Sometimes serious cardiac injury may manifest only subtle or occult symptoms or signs. Cardiac foreign bodies induced cardiac penetrating injury infrequently and may lead to unpredictable complications, especially for those with sharp nature. However, we know little about the migrating paths or the foreign bodies location changes of such cases. As there is a rarely reported case of cardiac penetrating injury caused by a self-inflicted needle that migrated from the neck to the heart, we herein present a review of such injury on dynamic monitoring using perioperative echocardiography showed the needle shuttled through the ventricular wall along with increasing pericardial effusion.