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Heart Failure in Cardiac Amyloidosis: Suspecting a ...
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This document discusses transthyretin cardiac amyloidosis (ATTR-CA), a highly prevalent and underdiagnosed cause of heart failure (HF). It provides a list of "clinical red flags" that can indicate ATTR-CA, including bilateral carpal tunnel syndrome, repeat HF admissions, worsening HF despite medication compliance, and autonomic dysfunction. The document also outlines the recommended order for diagnostic tests, which includes an ECG, echo with strain, ruling out light chain amyloidosis, a pyrophosphate (PYP) scan, and a cardiology clinic referral. It notes that a low voltage ECG and a positive PYP scan are highly specific indicators of ATTR-CA. The document emphasizes that ATTR-CA is more prevalent in elderly individuals and carries a 4% prevalence in African American populations with a specific mutation. It also suggests obtaining more resources on ATTR-CA.
Keywords
transthyretin cardiac amyloidosis
ATTR-CA
heart failure
clinical red flags
bilateral carpal tunnel syndrome
diagnostic tests
ECG
echo with strain
PYP scan
cardiology clinic referral
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