Diagnostic algorithm of cardiac amyloidosis

Once cardiac amyloidosis (CA) is suspected, a timely and conclusive diagnosis should be obtained. Indeed, patient outcomes depend mainly on early initiation of therapy. In the past, a diagnosis of CA could be done only with the histologic confirmation of a myocardial amyloidotic infiltration. However, performing a myocardial biopsy in the heart is a procedure not free from complications and should be done in expert centers, making CA diagnoses extremely complex and limited. In 2016 it has been proposed a diagnostic algorithm that allows a non invasive approach to diagnose cardiac amyloidosis. It couples the results of bone scintigraphy (specific for transthyretin -TTR – amyloidosis) and hematological blood and urine test (specific for monoclonal immunoglobulin light chain – AL – amyloidosis). Since the introduction of this algorithm an amazing increase of cardiac amyloidosis diagnoses was observed.