Heart with magnifying glass revealing a maze in a ventricle, alongside text reading 'ATTR-CM suspect & detect, uncover the clues for diagnosis'

Home > Diagnosis of ATTR-CM > Recognising signs and symptoms of ATTR-CM

 

Recognising signs and symptoms of Transthyretin Amyloid Cardiomyopathy (ATTR-CM)

 

Patients with wild-type ATTR and hereditary ATTR present with heart failure, particularly heart failure with preserved ejection fraction (HFpEF),1,2,3 and other cardiac symptoms.3-6

| Common signs and symptoms in wild-type ATTR and hereditary ATTR3,4,7-11

 

A diagram containing two bodies, showing front and back profiles, with arrows pointing to various body parts, indicating the signs and symptoms of ATTR-CM

Adapted with permission from Wolters Kluwer Health, Inc3

| Investigating heart failure with preserved ejection fraction and infiltrative cardiac disease

Prof. Perry Elliot of Bart’s Heart Centre summarises his symposium speech, presenting the key characteristics to help identify HFpEF and explore the potential causes.

Professor Perry Elliott, Professor of Cardiovascular Medicine, University College London and Research Lead of the Inherited Cardiovascular Disease Unit, Bart’s Heart Centre

This symposium at the BCS Annual Conference 2019 was an educational symposium organised and sponsored by Pfizer. The content of the symposium was developed and agreed by the faculty.

| Cardiac

  • Fatigue
  • Shortness of breath
  • Oedema
  • Arrhythmias
  • HFpEF
  • Aortic stenosis
  • Orthostatic hypotension
  • Erectile dysfunction

| Soft tissue

  • Lumbar stenosis
  • Ruptured distal biceps tendon
  • Eye involvement – glaucoma, intravitreal deposition, scalloped pupils

| GI

  • Diarrhoea
  • Constipation
  • Nausea
  • Early satiety

| Neurologic

  • Carpal tunnel syndrome (CTS)
  • Sensory-motor polyneuropathy
  • Weakness

NEXT SECTION: Consider the clinical clues to identify ATTR-CM and the need for further testing >

 

 

References

  1. González-López E, Gallego-Delgado M, Guzzo-Merello G, et al. Wild-type transthyretin amyloidosis as a cause of heart failure with preserved ejection fraction. Eur Heart J. 2015; 36(38): 2585–2594. 
  2. Mohammed SF, Mirzoyev SA, Edwards WD et al. Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction. JACC Heart Fail. 2014; 2(2): 113–122.
  3. Nativi-Nicolau J, Maurer MS. Amyloidosis cardiomyopathy: update in the diagnosis and treatment of the most common types. Curr Opin Cardiol. 2018; 33(5): 571–579. 
  4. Connors LH, Sam F, Skinner M et al. Heart Failure Due to Age-Related Cardiac Amyloid Disease Associated With Wild-Type Transthyretin: A Prospective, Observational Cohort Study. Circulation. 2016; 133(3): 282–290.
  5. Maurer MS, Hanna M, Grogan M et al. Genotype and Phenotype of Transthyretin Cardiac Amyloidosis. J Am Coll Cardiol. 2016; 68(2): 161–172. 
  6. Pinney JH, Whelan CJ, Petrie A et al. Senile Systemic Amyloidosis: Clinical Features at Presentation and Outcome. J Am Heart Assoc. 2013; 2(2): e000098.
  7. Sperry BW, Reyes BA, Ikram A et al. Tenosynovial and Cardiac Amyloidosis in Patients Undergoing Carpal Tunnel Release. J Am Coll Cardiol. 2018; 72(17): 2040-2050. 
  8. Geller HI, Singh A, Alexander KM et al. Association Between Ruptured Distal Biceps Tendon and Wild-Type Transthyretin Cardiac Amyloidosis. JAMA. 2017; 318(10): 962–963.
  9. Galat A, Guellich A, Bodez D et al. Aortic stenosis and transthyretin cardiac amyloidosis: the chicken or the egg? Eur Heart J. 2016; 37(47): 3525–3531.
  10. Yanagisawa A, Ueda M, Sueyoshi T et al. Amyloid deposits derived from transthyretin in the ligamentum flavum as related to lumbar spinal canal stenosis. Mod Pathol. 2015; 28(2): 201–207.
  11. Witteles RM, Bokhari S, Damy T et al. Screening for Transthyretin Amyloid Cardiomyopathy in Everyday Practice. JACC Heart Fail. 2019; 7(8): 709–716.

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