CARDIAC AMYLOIDOSIS: PRINCIPLES, DIAGNOSIS, AND MANAGEMENT

Heart failure with preserved ejection fraction. Unexplained left ventricular thickening. Low voltage on ECG that doesn’t match the echo. Bilateral carpal tunnel syndrome years before cardiac symptoms.

What if we have been missing the diagnosis?

Cardiac amyloidosis is no longer a medical curiosity. With advances in imaging, molecular typing, and transformative therapies for both AL (light chain) and ATTR (transthyretin) amyloidosis, early recognition is now lifesaving. Yet many clinicians still encounter delayed diagnoses, therapeutic uncertainty, and fragmented care pathways.

CARDIAC AMYLOIDOSIS: PRINCIPLES, DIAGNOSIS, AND MANAGEMENT is a comprehensive, clinically grounded, and future-focused reference designed to change that.

This book takes readers from first principles to cutting-edge innovation in a structured, clinically intuitive journey:

Foundations: From Misfolded Protein to Failing Heart

The history of amyloidosis—from Virchow’s early observations to modern molecular breakthroughs

Mechanisms of protein misfolding, fibrillogenesis, and organotropism

Why the heart becomes the target organ

Chemical classification and the crucial distinction between AL and ATTR

Epidemiology, racial disparities, and genetic penetrance

Clinical Suspicion: Recognizing the “Red Flags”

The mismatch between ECG voltage and wall thickness

HFpEF as a common masquerade

Orthopedic clues: carpal tunnel, spinal stenosis, tendon rupture

Autonomic dysfunction and extracardiac manifestations

A practical differential diagnosis including HCM, Fabry disease, sarcoidosis, and more

Imaging Mastery

ECG patterns and conduction disease

Transthoracic echo basics and advanced strain imaging (the classic “apical sparing” pattern)

Cardiac MRI with T1 mapping and Late Gadolinium Enhancement

Nuclear scintigraphy with Tc-99m PYP and Perugini grading

SPECT/CT and PET tracers in clinical and research settings

Diagnostic Precision

Biomarker staging systems (Mayo, Gilmore)

Monoclonal protein screening algorithms

Extracardiac and endomyocardial biopsy techniques

Congo Red staining, immunohistochemistry pitfalls, and laser microdissection mass spectrometry—the gold standard

Disease-Specific Management

The urgency of AL amyloidosis and modern chemotherapy regimens

Stem cell transplantation and relapsed disease strategies

ATTR therapies: TTR stabilizers, RNA silencers, and gene editing

Emerging anti-amyloid degraders and CRISPR-based approaches

Practical Cardiology in Amyloid Patients

Fluid management within a narrow therapeutic window

Medications to avoid—and why

Atrial fibrillation, anticoagulation, and device therapy

ICD controversies and shared decision-making

Mechanical circulatory support and transplant considerations

Beyond the Heart

Neurologic, renal, and gastrointestinal management

Financial toxicity and patient advocacy

Palliative care integration

Building a multidisciplinary amyloid center

The future of AI-driven screening and personalized medicine

This is more than a textbook—it is a clinical playbook.

Whether you are:

A cardiologist managing unexplained HFpEF

A hematologist treating plasma cell dyscrasia

An internist encountering subtle red flags

A cardiac imager refining diagnostic algorithms

A trainee seeking structured mastery

Or a healthcare system leader building an amyloid program