Cardiac amyloidosis

Abstract

Systemic amyloidosis commonly affects the heart. Indeed, cardiac symptoms may be the first clinical indicator of underlying amyloid deposition. Using two case studies, this article reviews the latest evidence regarding cardiac amyloidosis. The diagnosis of cardiac involvement can be established through imaging with echocardiography and magnetic resonance. Supportive evidence may be gained from biochemical markers such as serum N-terminal probrain natriuretic peptide (NT-proBNP). The main clinical consequences of amyloid deposition are cardiac failure and rhythm disturbances. Attempts to cure the underlying disease process with chemotherapy and/or cardiac and/or liver transplantation have had variable results. Stem-cell transplantation is associated with significant mortality in the context of cardiac involvement. Although newer therapeutic agents are emerging, the overall outlook at this time remains poor.