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Amyloid cardiomyopathy: a hidden heart failure cause that is often misdiagnosed

Yale Tung-Chen1, Miguel-Ángel Arnau2

  • 1a Emergency Department , Hospital Universitario La Paz , Madrid , Spain.

Acta Clinica Belgica
|April 18, 2018
PubMed

Insights

Congestive heart failure (CHF) can be caused by cardiac amyloidosis, a condition often overlooked in elderly patients. Early suspicion and diagnosis are crucial for appropriate management of this CHF cause.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pathology

Background:

  • Congestive heart failure (CHF) is a prevalent condition, particularly in older adults, marked by symptoms like dyspnea and edema.
  • Amyloid cardiomyopathy is an underdiagnosed cause of CHF.

Observation:

  • A 76-year-old patient presented with 3 months of CHF symptoms.
  • ECG and echocardiogram suggested CHF secondary to amyloid cardiomyopathy.
  • Cardiac MRI, positive subcutaneous fat aspirate Congo red staining, and negative genetic testing for mutant transthyretin indicated senile amyloid cardiomyopathy (ATTRw).

Findings:

  • Cardiac amyloidosis is significantly underdiagnosed.
  • Diagnosis requires a high index of suspicion, especially in elderly patients with CHF symptoms.
  • Senile amyloid cardiomyopathy (ATTRw) was the suspected diagnosis in this case.

Implications:

  • Recognizing cardiac amyloidosis is vital for effective CHF management.
  • Treatment for cardiac amyloidosis differs from other CHF etiologies, necessitating specific diagnostic approaches.
  • Increased clinical awareness can improve patient outcomes for this underdiagnosed condition.
Abstract

Keywords:
Congestive heart failureamyloidosiscardiomyopathymonoclonal immunoglobulin light chaintransthyretin

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