A Change of Heart (Care Practices): Recognizing and Managing Transthyretin Amyloid Cardiomyopathy

Overview
Transthyretin amyloid cardiomyopathy (ATTR-CM), once considered rare, may be more prevalent than thought. Diagnosing this condition can be a challenge, as early symptoms are often attributed to aging and later, more severe, symptoms can mimic the symptoms of other conditions such as heart failure (HF) and aortic stenosis. This can be particularly problematic, as several treatments common to these conditions are contraindicated for patients with ATTR-CM. Moreover, clinicians may not be aware that advances in noninvasive methods, such as cardiac magnetic resonance and bone scintigraphy, can provide definitive diagnostic results and have largely supplanted the historic gold standard for ATTR-CM diagnosis, endomyocardial biopsy.

This activity examines strategies for reducing the threshold for clinical suspicion of ATTR-CM, particularly in patients diagnosed with HF and atrial fibrillation who have inconsistencies in their presentations of these conditions, and provides current clinical evidence supporting the effectiveness of noninvasive diagnostic methods and emerging treatments for the management of patients with ATTR-CM.

Target Audience
This activity has been designed to meet the educational needs of primary care providers, cardiologists, and other health care professionals involved in the management of patients who have or are at risk for ATTR-CM.

Learning Objectives
Upon completion of this activity, participants should be able to:
- Identify signs and symptoms (including early warning signs and red flags) that, in conjunction with other comorbid cardiac conditions, should raise suspicion of ATTR-CM
- Outline the noninvasive diagnostic paradigm for ATTR-CM
- Evaluate emerging data on treatment advances for patients with ATTR-CM