Concomitant Cardiac Transthyretin Amyloidosis and Coronary Artery Disease---Imaging Features and Pitfalls

Area of Science:

• Cardiology
• Medical Imaging
• Cardiovascular Diseases

Background:

• Coexistence of coronary artery disease (CAD) and transthyretin cardiac amyloidosis (ATTR-CM) is increasingly observed, particularly in elderly populations.
• Distinct pathophysiologic and imaging characteristics of CAD and ATTR-CM can complicate diagnosis when they occur together.

Purpose of the Study:

• To increase awareness of ATTR-CM in patients already diagnosed with CAD.
• To discuss multimodality imaging findings in patients with concurrent CAD and ATTR-CM.
• To highlight diagnostic challenges and the importance of recognizing atypical presentations of both conditions.

Main Methods:

• Presentation of a series of clinical cases.
• Illustration of multimodality imaging findings including echocardiography, cardiac magnetic resonance imaging, nuclear imaging, and coronarography.
• Analysis of unique and overlapping imaging features in patients with coexisting CAD and ATTR-CM.

Main Results:

• Demonstration of specific multi-imaging features and findings in patients with concomitant CAD and ATTR-CM.
• Identification of challenges in interpreting imaging and diagnosing patients with both conditions.
• Emphasis on the value of recognizing atypical presentations of CAD and ATTR-CM.

Conclusions:

• Multimodality imaging plays a crucial role in diagnosing the complex interplay of CAD and ATTR-CM.
• Awareness of potential ATTR-CM in CAD patients and recognition of specific imaging patterns are vital for accurate diagnosis.
• Understanding overlapping and unique imaging features aids in managing patients with these coexisting cardiovascular diseases.