Microfibrillar cardiomyopathy is a very rare cause of restrictive cardiomyopathy (RCM).The index case was a male patient who presented with shortness of breath and Spur Pads pedal edema.Further clinical investigations favored a clinical diagnosis of RCM.An endomyocardial biopsy revealed subendocardial and interstitial hyaline eosinophillic material resembling amyloid that did not stain with Congo red.
An electron microscopic examination showed that this material was composed of twisted linear and bundles of tangled microfibrils.The etiology of the microfibrillar deposition is currently unknown.The pathologists should entertain the diagnosis of Crossbody Strap microfibrillar cardiomyopathy in suspected cases of amyloidosis that are negative for Congo red.