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The pathway from suspicion to diagnosis

It is important to clinically differentiate between transthyretin cardiac amyloidosis* and immunoglobulin light chain amyloidosis (AL), as they have different clinical courses. AL is often addressed by a hematologist/oncologist and requires immediate attention.1,2

*Also known as transthyretin amyloid cardiomyopathy (ATTR-CM).

A proposed algorithm for diagnosing ATTR cardiac amyloidosis in patients with suspected cardiac amyloidosis3:

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ATTR=transthyretin amyloidosis.References:Rapezzi C, Merlini G, Quarta CC, et al. Systemic cardiac amyloidoses: disease profiles and clinical courses of the 3 main types. Circulation. 2009;120(13):1203-1212.Donnelly JP, Hanna M. Cardiac amyloidosis: an update on diagnosis and treatment. Cleve Clin J Med. 2017;84(12 suppl 3):12-26.Maurer MS, Bokhari S, Damy T, et al. Expert consensus recommendations for the suspicion and diagnosis of transthyretin cardiac amyloidosis. Circ Heart Fail. 2019;12(9):e006075.
Diagnosis

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