Heart Failure in Cardiac Amyloidosis: Suspecting and Diagnosing Transthyretin Amyloid Cardiomyopathy in Underdiagnosed Populations at Risk for Heart Failure-Think Amyloid Cardiology Specialty Clinics Poster

Think Amyloid Cardiology Specialty Clinics Poster

Pdf Summary

Transthyretin cardiac amyloidosis (ATTR-CA) is a common and often undiagnosed cause of heart failure. It is important to consider amyloidosis in patients who are over 60 years old, African American, or elderly with heart failure. To diagnose ATTR-CA, a pyrophosphate (PYP) scan can be done, and other causes of amyloidosis should be ruled out through serum and urine tests, as well as genetic testing. Clinical red flags for ATTR-CA include orthostatic hypotension or polyneuropathy, lumbar spinal stenosis, heart failure with preserved or reduced ejection fraction, repeated heart failure admissions, intolerance to heart failure guideline-directed medical therapy, and chronic low-level troponin elevation. Bilateral carpal tunnel syndrome and arrhythmias, such as atrial fibrillation and heart blocks, can also be indicators of ATTR-CA. Additional red flags on cardiovascular testing include diffuse subendocardial late gadolinium enhancement on cardiac magnetic resonance imaging (CMR) and low voltage on electrocardiogram (ECG). Confirmatory testing for ATTR-CA includes a positive PYP scan, which is highly specific for the condition. Other symptoms associated with ATTR-CA include lightheadedness or syncope, chronic low back pain, and pain and numbness in the fingers. The poster is supported by an unrestricted educational grant from Pfizer, Inc.

Keywords

Transthyretin cardiac amyloidosis

ATTR-CA

heart failure

amyloidosis

PYP scan

serum and urine tests

genetic testing

orthostatic hypotension

polyneuropathy

atrial fibrillation