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Cardiac Amyloidosis

Cardiac amyloidosis occurs when plaques of protein byproduct called amyloid build up in heart muscle, affecting its ability to pump blood.
What You Need to Know
  • The two kinds most likely to damage the heart are light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR).
  • Treatment depends on the specific subtype of amyloidosis. It may involve medication, chemotherapy and stem cell transplantation.

Cardiac Amyloidosis Symptoms

Symptoms of cardiac amyloidosis mimic those of heart failure, including:

  • Thickened, less flexible heart tissue (restrictive cardiomyopathy, or “stiff heart syndrome”)
  • Shortness of breath
  • Fatigue
  • Swelling in the legs
  • Heart palpitations
  • Lightheadedness

Cardiac Amyloidosis Diagnosis

To confirm a diagnosis of cardiac amyloidosis, you will need either a cardiac biopsy or technetium pyrophosphate scan.

A cardiac biopsy involves taking a small sample of heart tissue that the doctor examines under the microscope.

A technetium pyrophosphate scan is similar to an MRI in that it gives a picture of the heart. A dye is injected before the scan and will cause transthyretin amyloidosis to “light up.” If either test indicates TTR amyloidosis, genetic testing is recommended to confirm the subtype.

Other tests that might be recommended:

Cardiac Amyloidosis Treatment

Cardiac amyloidosis is a serious condition that requires a multidisciplinary approach. Though the condition cannot be reversed, treatment may be able to slow the progression of the amyloid deposits and address damage to the heart.

Treatment depends on the subtype and may involve a combination of these approaches:

  • Medication to stabilize the TTR protein (for ATTR, not AL)
  • Medication to “silence” the TTR gene and prevent the body from producing the TTR protein (for ATTR, not AL)
  • Medications to reduce swelling or control irregular heartbeat
  • A pacemaker to regulate the heartbeat
  • Chemotherapy (for AL, not for ATTR)
  • Auto stem cell transplant (for AL, not for ATTR)
  • Clinical trial participation to test new therapies.
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