Signs and Symptoms of Cardiac Amyloidosis

Symptoms of Amyloidosis depend on the type of amyloid and the organs affected. AL amyloidosis commonly affects the kidney, and heart gastrointestinal tract, while ATTR amyloidosis affects the heart, nerves and joints.  

Symptoms due to the heart’s involvement:

  • Difficulty in breathing with minimal walking/exertion
  • Leg and ankle swelling
  • Abdominal swelling
  • Fatigue and weakness
  • Unable to lie flat in bed or sleeping with more pillows due to difficulty in breathing
  • Atrial fibrillation (irregular heart rhythm)
  • Heart blocks 

Symptoms due to Kidney involvement: 

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

Symptoms due to Gastrointestinal system:

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

Symptoms due to Nervous system: 

  • Neuropathy (loss of sensation, tingling, numbness, burning pain) in hands and feet (esp in absence of long-standing diabetes)
  • Dizziness and loss of consciousness. 
  • Diarrhea/constipation due to autonomic dysfunction
  • Sexual dysfunction in males

Symptoms due to involvement of ligaments and Joints:

  • Carpel tunnel syndrome especially in both hands (numbness and tingling of hands due to nerve compression at the wrist) requiring surgery. 
  • Lower backache due to spinal stenosis (narrowing of the spinal canal)
  • Multiple joint pains especially involving shoulder joints in the absence of any other cause. 
  • Spontaneous rupture of tendons especially biceps. 

Other symptoms:

  • Bleeding or easy bruising
  • Skin and nail changes