RECOGNISING THE CONSTELLATION OF ATTR AMYLOIDOSIS SIGNS AND SYMPTOMS IS IMPORTANT
Recognising the signs and symptoms of ATTR amyloidosis could help accelerate earlier identification of the disease1
Click or tap categories to view additional red flags.
Tap categories to view additional red flags.
SENSORIMOTOR NEUROPATHY1
Painful neuropathy
in hands and feet
Falls
Difficulty walking
Muscle weakness
CARDIAC1
HF (right-sided), HFpEF, or intolerance to ACEi, ARBs, ARNi, or beta blockers
Atrial fibrillation
Bradyarrhythmias/conduction abnormalities/need for pacemaker
MUSCULOSKELETAL1,5–7
Back pain/lumbar spinal stenosis
Ruptured distal biceps tendon/Popeye sign
Shoulder, knee and hip pain or surgery
Trigger finger
Bilateral carpal tunnel syndrome
AUTONOMIC DYSFUNCTION1
Orthostatic hypotension
Unexplained weight loss
Diarrhoea
Erectile dysfunction
Constipation
NEPHROPATHY4
Proteinuria
Renal failure
This list of signs and symptoms of ATTR is not intended to be exhaustive.
Watch this video to understand the disease course and signs/symptoms of ATTR amyloidosis
The “HIDDEN” mnemonic is a useful tool to help remember some of the commonly encountered “red flags” associated with ATTR-CM9
HFpEF and other cardiac conditions, including atrial fibrillation, arrhythmia and atrioventricular block10
Intolerance to standard heart failure therapies (e.g. ACEi/ARBs and beta blockers)11
Discordance of QRS voltage and left ventricular wall thickness seen on echocardiography12,13
Diagnosis of carpal tunnel syndrome, distal biceps tendon rupture or lumbar spinal stenosis14,15
Echocardiography showing increased left ventricular wall thickness and/or low-flow gradient aortic stenosis and additional echocardiography parameters*12
Nervous system—autonomic nervous system dysfunction, including gastrointestinal complaints or unexplained weight loss16
Figure adapted from Sabbour H, et al. Front Cardiovasc Med. 2021.9
*Echocardiographic, speckle-strain and tissue doppler “red flags”: Heart failure normal or mid-range ejection fraction; increased wall thickness; left atrial enlargement; low stroke volume index; low-flow, low-gradient aortic stenosis (per ESC/EACTS Guidelines);17 low myocardial contraction fraction; advanced diastolic dysfunction; impaired global longitudinal strain with apical sparing; low mitral annular tissue Doppler S' (average septal and lateral annulus).8
In most patients with ATTR-CM, misdiagnosis or delayed diagnosis may lead to irretrievable loss of quality of life and disease progression of polyneuropathic and cardiac symptoms1,4
ATTR amyloidosis is a progressive and potentially fatal disease caused by the buildup of amyloid fibrils in various tissues and organs1
Late-stage disease impacts responsiveness to certain treatments18
Increased burden of symptoms and disease18–20
Decreased life expectancy1,18–20
ATTR amyloidosis progresses to mortality1,18,19
Symptom deterioration may indicate disease progression
Worsening of symptoms can be a serious and potentially life-altering sign of disease progression1,19
Timely diagnosis and treatment of ATTR amyloidosis may help to improve patient outcomes4
Early intervention for ATTR amyloidosis may improve quality of life1–4,22–25
Get in touch
If you have any questions about ATTR amyloidosis in the United Kingdom or would like to speak to an AstraZeneca medical representative, please contact us
GB-62817 I April 2025
