Cardiac amyloidosis is a group of diseases caused by deposits of abnormal proteins, or amyloid, in the heart. Cardiac amyloidosis causes the heart to become stiff and makes it difficult for the heart to work properly. This can cause fluid to build-up in the lungs, leading to breathlessness, and fluid build-up in soft tissues leading to the legs, causing abdominal swelling. Because cardiac amyloidosis can cause symptoms that are very similar to other heart diseases, it is often misdiagnosed.
The Cardiac Amyloidosis Program at Brigham and Women's Hospital (BWH) is the only clinical program of its kind in the U.S. focusing specifically on this disease. Led by Rodney H. Falk, MD, a renowned cardiac amyloidosis expert, this multidisciplinary program draws on the expertise of some of the country's leading cardiology specialists who collaborate on research and patient care at the state-of-the-art Heart & Vascular Center.
Symptoms of cardiac amyloidosis
Because amyloidosis can affect other organs in addition to the heart, the spectrum of symptoms for cardiac amyloidosis can be quite broad, but may include:
Swelling in the legs, ankles, abdomen and other parts the body
Fatigue and reduced tolerance for activity
Difficulty breathing while lying down
Pressure or dull pain in the chest during exertion, similar to angina
Rodney H. Falk, MD, and the Brigham and Women’s Cardiac Amyloidosis Program are featured in this video. BWH's Cardiac Amyloidosis Program is the only clinical program in the U.S. focusing exclusively on cardiac amyloidosis. This unique program was established in order to help fill a significant void in the diagnosis and treatment of systemic amyloidosis, with a view to acquiring a better understanding of cardiac amyloidosis and improving care for patients who have the disease. Watch Part 2 of this video: Advancing the Diagnosis and Treatment of Cardiac Amyloidosis.
Treatment for cardiac amyloidosis
As patients with cardiac amyloidosis are very sensitive to sodium and retain fluid quickly, doctors will typically immediately limit salt intake. Diuretics may be prescribed to help the body remove excess fluid. Other treatments may include:
Chemotherapy for patients with light-chain associated (AL) amyloidosis and access to new investigational agents for amyloid of aging and familial cardiac amyloidosis.
Implantable cardioverter-defibrillator to treat atrial and ventricular arrhythmias
Pacemaker to manage problems with heart signals
Prednisone, an anti-inflammatory medicine
A heart transplant may be recommended for some patients with very poor heart function and certain types of cardiac amyloidosis.
The Cardiac Amyloidosis Program at BWH provides comprehensive diagnostic and treatment services that include cardiac biopsy, genetic testing for patients with suspected familial amyloidosis, and precise assessment of cardiac function by state-of-the-art, noninvasive testing.