Wahaj Ahmed, Maqsood Naima, Hassler Jared R, Patil Pravin V, Fabrizio Carly A
Rawalpindi Medical University, Rawalpindi, Pakistan.
Section of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania, USA.
JACC Case Rep. 2025 Apr 2;30(7):103390. doi: 10.1016/j.jaccas.2025.103390.
Cardiac Amyloidosis (CA).
When should infiltrative cardiomyopathy be suspected, and what is the differential diagnosis? What is the diagnostic yield of a technetium Tc 99m pyrophosphate (Tc-PYP) scan, cardiac magnetic resonance (CMR), and molecular imaging with amyloid positron emission tomography (PET) tracer for CA? Are they able to distinguish between types of CA? What is the diagnostic yield of an endomyocardial biopsy for CA? How is transthyretin amyloid cardiomyopathy (ATTR-CM), treated and what is the prognosis? How do tag team rounds build on the current system of diagnosis and management of CA?
Tag team rounds between heart failure, pathology, and hematology teams resulted in timely and accurate diagnosis of hereditary ATTR-CM in a patient with new-onset heart failure.
TAKE-HOME MESSAGE: A nonbiopsy diagnosis of CA is more challenging when a monoclonal gammopathy is present. Tag team rounds allow for correct and timely diagnosis of ATTR amyloid when a monoclonal protein is found.
心脏淀粉样变性（CA）。
何时应怀疑浸润性心肌病，其鉴别诊断是什么？锝 Tc 99m 焦磷酸盐（Tc-PYP）扫描、心脏磁共振成像（CMR）以及使用淀粉样蛋白正电子发射断层扫描（PET）示踪剂的分子成像对 CA 的诊断阳性率是多少？它们能否区分 CA 的类型？心内膜心肌活检对 CA 的诊断阳性率是多少？转甲状腺素蛋白淀粉样心肌病（ATTR-CM）如何治疗，预后如何？联合查房如何在当前 CA 的诊断和管理系统基础上进行改进？
心力衰竭、病理学和血液学团队之间的联合查房使得一名新发心力衰竭患者的遗传性 ATTR-CM 得到及时、准确的诊断。
当存在单克隆丙种球蛋白病时，CA 的非活检诊断更具挑战性。当发现单克隆蛋白时，联合查房有助于对 ATTR 淀粉样变性进行正确、及时的诊断。
