Cardiac amyloidosis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Aarti Narayan, M.B.B.S [3]; Cafer Zorkun, M.D., Ph.D. [4]; Lakshmi Gopalakrishnan, M.B.B.S. [5]

Amyloidosis is a multi-system disease involving many organs simultaneously. Approximately 50% of the patients with cardiac amyloidosis present with right heart failure symptoms. The most common symptoms observed in patients with cardiac amyloidosis include fatigue, weight loss, and periorbital purpura.

• Patients with cardiac amyloidosis present with signs and symptoms of heart failure.

Cardiac amyloidosis can be associated with the following symptoms:^[1]

• Congestive heart failure with associated symptoms such as
  • Fatigue
  • Dyspnea
  • Dizziness
  • Orthopnea^[2]
  • Peripheral edema
  • Weight loss due to cardiac cachexia
  • Ascites
• Arrhythmias with associated symptoms such as palpitations
• Syncope and presyncope
  • Syncope on exertion is an ominous sign of cardiac amyloidosis, as these patients cannot augment their cardiac output due to poor filling of the ventricle (restrictive cardiomyopathy).^[3]
• Postural hypotension may be observed in patients with subendothelial amyloid deposition.^[4]
• Chest pain or chest discomfort ^[5][6]
• Non-specific symptoms like:
  • Periorbital purpura
  • Poor appetite
  • Weight loss
  • Early satiety

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