The challenging diagnosis of cardiac amyloidosis

Cardiac  amyloidosis  is  a  rare  condition.  Early  diagnosis  allows  for more effective treatment with subsequent improvements in patient quality of life and  survival.  There  is,  however,  often  a  significant  delay  between  the  initial presentation  with  symptoms  and  the  eventual  diagnosis.  We  present  seven individual cases presenting to our centre over a 12-month period for whom the final  diagnosis  was  cardiac  amyloidosis. We  look  at  the  difficulties  encountered and alternative diagnoses that were considered before the eventual diagnosis of cardiac  amyloidosis  was  made.  We  discuss  the  apparent  discrepancies  often encountered between the clinical signs and the results of various investigations. We review the various tests that can help the clinician to make the diagnosis in patients  with  suspected  cardiac  amyloidosis  and  look  at  the  treatment  options. Finally, we conclude that careful evaluation of the clinical status in the context of all available results should allow early diagnosis and treatment, thereby improving long-term prognosis.