What are the signs and symptoms of cardiac amyloidosis?

Updated: Mar 25, 2020
  • Author: Gyanendra K Sharma, MD, FACC, FASE; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Systemic amyloidosis (AL) is a complex multisystem disorder, and symptoms depend on the organ involvement. [30] Symptoms occur because of infiltrative cardiomyopathy and diastolic dysfunction. Approximately half of the patients with cardiac involvement present with right-sided heart failure. Patients may present with the following signs and symptoms [20] :

  • Fatigue and weakness (most common symptoms)

  • Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea

  • Leg edema

  • Dyspnea

  • Dizziness

  • Presyncope/syncope [31]

  • Postural hypotension

  • Easy bruising

  • Angina [13, 32]

  • Pleural effusion, pulmonary edema (rare)

  • Sudden cardiac death

  • Pericardial effusion, cardiac tamponade (rare) [33]

  • Heart block [34]

  • Ischemic stroke (in 30% cases, cardioembolic in the remaining 70%) [35]

  • Painful polyneuropathy (10-20% cases)

  • Carpal tunnel syndrome (20%) [36]

  • Pulmonary amyloid infiltration, pulmonary hypertension, and cor pulmonale

  • Abnormal voice quality

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