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

Think Amyloid Primary Care Clinics Poster

Pdf Summary

This document discusses transthyretin amyloidosis, specifically focusing on the V142I mutation which has a prevalence of 4% in individuals of African American descent. The prevalence of wild-type ATTR-CA (amyloid cardiac amyloidosis) increases with age, particularly in elderly individuals. Some red flags for ATTR-CA include low voltage on an ECG, apical sparing strain pattern on echocardiography, repeat heart failure admissions, chronic low-level troponin elevation, bilateral carpal tunnel syndrome, atrial fibrillation/bradycardia/heart block, gastroparesis/vomiting/constipation, autonomic dysfunction (orthostatic hypotension or syncope), and polyneuropathy.<br /><br />The document recommends promptly ordering two initial tests for patients suspected of having ATTR-CA: a pyrophosphate (PYP) scan and tests to rule out light chain amyloidosis, including serum and urine kappa/lambda light chains and serum and urine immunofixation electrophoresis.<br /><br />The apical sparing strain pattern is discussed as a characteristic of transthyretin cardiac amyloidosis, which is a progressive and life-threatening infiltrative cardiomyopathy. Patients over 60 years old with clinical heart failure and a positive PYP scan (highly specific for ATTR-CA) are mentioned as being at risk for this condition.<br /><br />The document acknowledges Saurabh Malhotra, MD, MPH for developing the poster and states that it is supported by an unrestricted educational grant from Pfizer, Inc. It also encourages readers to hover over an image with their camera to access more resources on ATTR-CA.

Keywords

transthyretin amyloidosis

V142I mutation

prevalence

wild-type ATTR-CA

red flags

heart failure admissions

autonomic dysfunction

pyrophosphate scan

light chain amyloidosis

Saurabh Malhotra