Department of Medicine.
Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri.
Am J Cardiol. 2021 Dec 1;160:99-105. doi: 10.1016/j.amjcard.2021.08.045. Epub 2021 Oct 3.
Cardiac amyloidosis is an important clinical entity associated with significant morbidity and mortality. Although the signs and symptoms can be apparent early in the disease course, diagnoses are often made late because of inadequate recognition. A diagnosis of cardiac amyloidosis requires careful scrutiny of a patient's symptoms, an electrocardiogram, and imaging studies, including echocardiography and magnetic resonance imaging. Further evaluation is required through the measurement of serum and urine light chains and the use of bone scintigraphy imaging to differentiate transthyretin amyloidosis from light-chain cardiac amyloidosis. The available treatments have expanded tremendously in recent years and have improved outcomes in the population with this disorder. Thus, it has become increasingly important to diagnose cardiac amyloidosis and provide timely therapies. This article will clarify the various misconceptions about cardiac amyloidosis and provide a framework for primary care providers to better identify this disease in their practice.
心脏淀粉样变性是一种重要的临床实体,与显著的发病率和死亡率相关。尽管在疾病早期就可能出现明显的体征和症状,但由于认识不足,诊断往往较晚。心脏淀粉样变性的诊断需要仔细检查患者的症状、心电图和影像学研究,包括超声心动图和磁共振成像。进一步的评估需要通过测量血清和尿液中的轻链以及使用骨闪烁成像来区分转甲状腺素蛋白淀粉样变性和轻链心脏淀粉样变性。近年来,可用的治疗方法有了极大的扩展,改善了这种疾病患者的预后。因此,诊断心脏淀粉样变性并提供及时的治疗变得越来越重要。本文将澄清关于心脏淀粉样变性的各种误解,并为初级保健提供者在实践中更好地识别这种疾病提供一个框架。