Beyond the Heart: Exploring Extracardiac Manifestations in Cardiac Amyloidosis for Early Diagnosis.

Abstract

Purpose of review: This review examines extracardiac manifestations of cardiac amyloidosis and their potential role in early diagnosis and management. Multisystem involvement, including musculoskeletal, peripheral nervous system, and other extracardiac findings are highlighted to serve as red flags for earlier detection.

Recent findings: Early screening for high-risk individuals over 50 with CTS or spinal stenosis could enable earlier intervention. Peripheral neuropathy and CTS often precede cardiac involvement by 5-10 years, while spinal stenosis can precede it by 5-15 years. Other indicators include biceps tendon rupture, trigger finger, and gastrointestinal issues. MRI shows promise in detecting amyloid-related changes, especially wrist MRI. More studies are needed. Recognizing extracardiac findings may enable earlier diagnosis and intervention before significant cardiac dysfunction. Current workflows use extracardiac manifestations to detect cardiac amyloidosis after cardiac involvement. Integrating these insights earlier could identify amyloidosis years before cardiac issues, improving screening, patient outcomes, and guiding future therapies.