Overview

Cardiac amyloidosis is a form of infiltrative cardiomyopathy caused by deposition of misfolded proteins in the heart. This textbook covers the diagnosis and management of AL (light chain) and ATTR (transthyretin) cardiac amyloidosis. What This Book CoversClinical Recognition (Chapters 3-4) Signs and symptoms of cardiac amyloidosis, physical examination findings, and clinical red flags across different practice settings including heart failure clinics, cardiology practices, and primary care. Diagnostic Methods (Chapters 5-14) Electrocardiography findings including low voltage patterns, echocardiography with strain imaging and apical sparing patterns, cardiac biomarkers (natriuretic peptides and troponins), cardiac MRI tissue characterization, bone scintigraphy for noninvasive ATTR diagnosis, endomyocardial biopsy techniques, genetic testing for hereditary ATTR, and step-by-step diagnostic algorithms. Disease Staging (Chapter 15) Biomarker-based staging systems including Mayo Clinic staging for AL amyloidosis and NAC staging for ATTR amyloidosis, imaging-based prognostic markers, and survival data by stage. Treatment of AL Amyloidosis (Chapter 16) Chemotherapy regimens including bortezomib-based combinations (CyBorD), daratumumab-based therapy, autologous stem cell transplantation, monitoring of hematologic and cardiac response, and management of treatment complications. Treatment of ATTR Amyloidosis (Chapter 17) TTR stabilizer therapy (tafamidis), TTR silencer therapies (patisiran, vutrisiran), investigational gene editing approaches, liver transplantation for hereditary ATTR, and treatment selection based on wild-type versus variant ATTR. Supportive Cardiac Care (Chapters 18-21) Diuretic management, medications to avoid in cardiac amyloidosis (ACE inhibitors, calcium channel blockers), arrhythmia management including atrial fibrillation and heart block, pacemaker and ICD considerations, and cardiac transplantation candidacy. Special Clinical Scenarios (Chapter 22) Concurrent aortic stenosis and cardiac amyloidosis, prevalence in patients undergoing TAVR, diagnostic approach, and management strategy.

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