Algorithms for Cardiac Amyloidosis Diagnosis: How to apply them in practice?

Diagnostic suspicion

The main obstacle to rapid and proper diagnosis of cardiac amyloidosis is the absence of early suspicion in patients who have clinical hints (red flags) that could – or should – trigger an investigation. This phenomenon becomes even more clear when it is documented that before the definitive diagnosis of amyloidosis or cardiac involvement due to amyloid deposition, investigation may take several months or years, usually involving many doctors from different specialties. In a study by the University of Toulouse, the average delay between the onset of symptoms and the diagnosis of amyloidosis was 8, 10 and 18 months, respectively,

for light chain amyloidosis (AL), wild-type transthyretin amyloidosis and hereditary transthyretin amyloidosis. Similarly, the number of health professionals that each patient needs to consult on their “journey” for the correct diagnosis may vary substantially. In interviews with family members and patients with amyloidosis, predominantly due to deposition

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