Cardiac amyloidosis: a case review series

Amyloidosis includes a spectrum of diseases that involve the deposition of misfolded proteins in various tissues throughout the body. There are many different proteins known to cause amyloidosis and the etiology of the amyloid subtype determines where the abnormal proteins deposit. AL, ATTRwt (formerly senile systemic amyloidosis), and ATTRm (formerly familial amyloidosis) are the most common amyloid subtypes that infiltrate cardiac tissue, resulting in a restrictive cardiomyopathy. In this series we report one case of each cardiac amyloidosis subtype, AL, ATTRwt, and ATTRm, that presented to Harbor-UCLA Medical Center between 2012-2013. All three patients had biopsies confirming cardiac amyloidosis as well as a cardiac MRI. Unfortunately, two of the three patients with cardiac amyloidosis passed away from PEA arrest illustrating the high mortality rate for this disease process. Since early diagnosis and treatment has shown improved median survival rates, we aim to review the diagnostic evaluation, treatment approaches, and prognosis for AL, ATTRwt, and ATTRm cardiac amyloidosis.