Transthyretin Amyloid Cardiomyopathy (ATTR-CM) is a rare, and ultimately fatal disease, characterised by the deposition of amyloid fibrils in the myocardium, leading to heart failure.^1,2 

Symptoms onset typically over the age of 50-60 years and include:^3,4

• ​​​​​​​^{​​​​​​​​​​​​​​}shortness of breath​​​​​​​
• cardiac arrhythmias, particularly atrial fibrillation​​​​​​
• heart failure
• oedema​​​​​​
• fatigue
• orthostasis
• angina

Cardiac signs include arrhythmias, thickening of the ventricular walls and interventricular septum, as well as cardiomyopathy, resulting in heart failure.⁴

The disease results in considerable physical and emotional impact for patients and their carers across multiple domains.​⁵

In the UK there is a delay to diagnosis (>4 years in 42% of cases of wild-type ATTR-CM). Barriers to diagnosis are thought to be a major reason for shortened survival with patients using hospital services a median (interquartile range) of 17 (9–27) times during the 3 years before diagnosis; by which time physical function and quality of life is greatly depleted.²

At this point, the prognosis of patients with ATTR-CM is poor; median survival in the UK varies between 2 and 5.5 years.^2,6,7

The prognosis worsens with continued amyloid deposits, therefore early diagnosis is key to improving patient outcomes.^1,6