Red Flags Suggesting Cardiac Transthyretin Amyloidosis (ATTR) in Clinical Practice

Praxis (Bern 1994). 2023 Apr;112(5-6):357-361. doi: 10.1024/1661-8157/a004001.

Abstract

Cardiac wtATTR is caused by extracellular deposition of misfolded proteins in the heart. It mostly affects elderly men and is still clearly underdiagnosed. Recognizing red flags suggesting wtATTR is key for a timely diagnosis, enabling the patient to profit from effective therapies. If general practitioners suspect cardiac amyloidosis, it is crucial to rapidly exclude AL-amyloidosis by immunoelectrophoresis, immunofixation as well as light-chain assay, because AL-amyloidosis needs urgent hematologic therapy. After that, the patient should be referred to the cardiologist for further assessment.

Keywords: Diastolic dysfunction; Diastolische Dysfunktion; Dysfonctionnement diastolique; Herzinsuffizienz; Karpaltunnelsyndrom; Polyneuropathie; Spinalkanalstenose; carpal tunnel syndrome; heart failure; insuffisance cardiaque; lumbar spinal stenosis; polyneuropathie; polyneuropathy; sténose spinale lombaire; syndrome du canal carpien.

MeSH terms

  • Aged
  • Amyloid Neuropathies, Familial* / complications
  • Amyloid Neuropathies, Familial* / diagnosis
  • Amyloid Neuropathies, Familial* / drug therapy
  • Cardiomyopathies* / diagnosis
  • Heart
  • Humans
  • Male

Supplementary concepts

  • Amyloidosis, Hereditary, Transthyretin-Related