Diagnosis of wild-type transthyretin amyloid cardiomyopathy by primary care physicians in Saint Petersburg. Literature review and clinical case

Cardiac age-related transthyretin amyloidosis is an underdiagnosed reason of heart failure with preserved ejection fraction, the most frequent form of heart failure. We present a clinical case of detection of transthyretin amyloidosis of the heart at stage I-II of the disease based on biomarkers, which made it possible to send the patient to a third-level hospital and achieve the maximum possible compensation for the disease. Based on this case report, we review modern algorithms allowing to suspect and make the diagnosis, from performing routine tests like ECG and echocardiography to more sophisticated instruments like 2D strain-echocardiography, radiology and endomyocardial biopsy. Also staging systems using biomarkers for cardiac transthyretin amyloidosis are discussed. We consider possible paths to early diagnosis of this disease and nuances of medical therapy.