Signs and Symptoms of Cardiac Amyloidosis

What are the signs and symptoms of amyloidosis?

Symptoms of amyloidosis depend on the type of amyloid and organs affected. AL amyloid commonly affects the kidney, heart, and gastrointestinal tract. ATTR affects the heart, nerves and orthopedic tissues (joints, tendons, ligaments).

  • Difficulty breathing with minimal walking/exertion
  • Swelling of the legs and ankles
  • Abdominal swelling
  • Fatigue and weakness
  • Unable to lie flat in bed or sleeping with more pillows due to difficulty breathing
  • Atrial fibrillation (irregular heart rhythm)
  • Heart blocks
  • Narrowing of heart (aortic) valve
  • Increased heart muscle thickness on echocardiography
  • Intolerance (dizziness, hypotension) to standard heart failure medications

  • Foamy urine – due to increased loss of protein in the urine
  • Swelling of legs and ankles
  • Puffy or swollen eyelids in the early morning
  • Some patients may go on to develop kidney failure requiring dialysis

  • Enlargement of the tongue
  • Unintentional weight loss
  • Diarrhea or constipation
  • Swallowing difficulty
  • Malabsorption

  • Neuropathy (loss of sensation, tingling, numbness, burning pain) in hands and feet (especially in the absence of long-standing diabetes)
  • Dizziness and loss of consciousness upon standing (orthostatic hypotension)
  • Diarrhea or constipation due to autonomic dysfunction
  • Sexual dysfunction in males

  • Carpel tunnel syndrome hands (numbness and tingling of hands due to nerve compression at the wrist), especially in both hands, requiring surgery
  • Lower backache due to spinal stenosis (narrowing of the spinal canal)
  • Multiple joint pains especially involving shoulder joints, without any other cause
  • Spontaneous rupture of tendons, especially biceps

  • Bleeding or easy bruising
  • Skin and nail changes