Transthyretin Cardiac Amyloidosis An Evolution in Diagnosis and Management of an "Old" Disease

ATTR-CA is a progressive, infiltrative, and restrictive cardiomyopathy, which remains an under-appreciated and under-diagnosed cause of HFpEF. The importance of enhanced suspicion and early diagnosis cannot be overemphasized, as emerging therapies are more effective early in the course of the disease. Further, because of the unique physiologic and hemodynamic features of CA, patients poorly tolerate traditional heart failure medications and experience worse outcomes compared with other causes of HFpEF. ATTR CA is increasingly recognized due to enhanced clinical awareness, advances in diagnostic imaging that allow noninvasive diagnosis, as well as the recent introduction of novel disease-modifying treatments.