Multimodality imaging approach to cardiac amyloidosis: part 2.

Abstract

With recent advances in cardiac imaging, genetics, and treatment options, cardiac amyloidosis (CA) is now recognized as an important and under diagnosed condition contributing to cardiovascular morbidity and mortality. Although still considered a rare disease, CA is now recognized as an important contributorto heart failure with preserved ejection fraction (HFPEF) andlow gradient aortic stenosis, twoimportant conditions commonly faced in clinicalpractice. This review uses clinicalscenarios to highlight the complementary role of traditionalimaging tools such as electrocardiogram (ECG) and echocardiography (echo) in conjunction withadvanced cardiac imaging with cardiac magnetic resonance (CMR) and nuclear cardiac scintigraphy using bone avid tracers in the comprehensive workup of CA. We also highlight the importance of workup of light chain disease as part of integration of imaging findings anddiscussthe key aspects of various imaging modalities. Finally, an algorithm integrating clinical suspicion, laboratory testing, and imagingin the workup of CA is presented.