Transthyretin Amyloid Cardiomyopathy as the Cause of Aortic Stenosis

Currently, the diagnosis of amyloid cardiomyopathy (ACM) causes great difficulties both for practicing primary care physicians and specialists. One of the reasons is the variety of symptoms in patients with ACM. The most common ACM manifestations include heart failure with preserved left ventricular ejection fraction, hypertrophic phenotype of cardiomyopathy, thromboembolic complications, and valvular apparatus damage. Common valvular manifestations are mitral and tricuspid valve insufficiency and aortic stenosis (AS). Diagnosis is particularly difficult in patients with AS requiring differentiation between AS as a degenerative defect and AS of amyloid origin. According to the literature, in 4-16% of cases of older patients (≥65 years), the genesis of AS is precisely the amyloid damage.

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