TRANSTHYRETIN CARDIAC AMYLOIDOSIS REVEALED BY MULTIMODALITY IMAGING IN AN ELDERLY PATIENT WITH HFpEF

Abstract

Amyloid cardiomyopathy is an infiltrative disease caused by extracellular deposition of amyloid fibrils within the myocardium, most commonly from immunoglobulin light-chain (AL) or transthyretin (ATTR) sources, leading to progressive heart failure, arrhythmias, and conduction disturbances. We present the case of an 80-year-old man with heart failure with preserved ejection fraction (HFpEF) and comorbidities who was admitted for acute onset dyspnea accompanied by profound hypotension at home. Together with a non-clonal free light-chain profile, these findings supported a diagnosis of transthyretin (ATTR) cardiac amyloidosis. This case highlights the value of integrating electrocardiogram, echocardiography, cardiac magnetic resonance, and bone-avid tracer scintigraphy to establish the diagnosis of ATTR cardiomyopathy and guide management in settings where disease-modifying therapy remains limited.Keywords: supraclavicular brachial plexus nerve block, adductor canal block, popliteal sciatic block, heart failure, limb amputation.