Overcoming Challenges to Recognizing, Diagnosing, and Managing Transthyretin Amyloid Cardiomyopathy

Transthyretin amyloid cardiomyopathy (ATTR-CM), once considered rare, is more prevalent than previously thought. Diagnosing this condition can be a challenge, as early symptoms may be nonspecific and attributable to aging, whereas later more severe symptoms can be mistaken for other cardiovascular conditions such as heart failure or may be confused with other causes of amyloidosis. This can be particularly problematic, as it can delay appropriate treatment.

Advances in noninvasive methods for definitively diagnosing ATTR-CM, such as bone scintigraphy, have largely supplanted endomyocardial biopsy, reducing the high threshold previously required for suspecting ATTR-CM. Until recently, treatment for ATTR-CM was limited to heart or liver transplant, but new and emerging treatments have given clinicians more options for effectively treating this disease.

In this RME Hot Seat, our expert faculty answers challenging clinical questions relating to ATTR-CM patient care, including on such issues as when to suspect the disease, who to screen, how to confirm diagnosis, determining prognosis, and current and emerging therapies for managing ATTR-CM.