Diagnosis and Treatment for Cardiac Amyloidosis

Cardiac amyloidosis can do undiagnosed for years as it can mimic other conditions. Cardiac amyloidosis is a progressive disease and early diagnosis is critical in altering the course of the disease. It is important to talk to specialists in the field if you have symptoms of amyloidosis like congestive heart failure, shortness of breath, irregular heart rhythm, neuropathy, unexplained stroke, swelling of legs/ankles or kidney dysfunction. SIU Medicine specialists use the following tests to arrive at the correct diagnosis:

1.    Detailed history and physical examination
2.    Review of previous medical records
3.    Electrocardiogram (EKG) – this will be done in the heart doctor’s office
4.    Ultrasound of the heart (Echocardiogram) 
5.    Blood tests
6.    Urine tests
7.    Nuclear medicine scan – safe to be done in patients with kidney disease and does not involve contrast/dye. 
8.    Cardiac MRI – if needed
9.    Biopsy — in rare circumstances 

These tests help the specialists to determine the type of amyloid and the extent of cardiac amyloidosis. Based on the test results further course of treatment and/or referral to other specialists will be made. 

Treatment for Amyloid Heart Disease:
SIU providers who specialize in the treatment and management of amyloidosis work as a team to provide the highest level of patient care. Treatment of amyloidosis depends on the symptoms, type of amyloidosis, organs affected and how far the disease has progressed. The main goal of treatment in any type of amyloidosis is to slow down or stop the production. Treatment success depends on an early diagnosis and type of amyloid. 

Patients with symptoms of congestive heart failure who have shortness of breath and swelling of ankles/legs due to excess of fluid retention are treated with diuretics and appropriate lifestyle modification recommendations. 

Patients with heart rhythm problems like heart blocks or arrhythmias will be managed jointly with electrophysiologists.
Patients with very advanced heart disease will be sent to higher centers for evaluation and consideration for a heart transplant. 

Certain common heart medications may not be well tolerated by patients with amyloid heart disease and may be very sensitive to the side effects. Hence, administration of cardiac medications should be done with caution.