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. 2023 Jul 11;16(7):523–535. doi: 10.1161/CIRCIMAGING.123.015259

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© 2023 The Authors. Circulation: Cardiovascular Imaging is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc.

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Figure 6. — Diagram illustrating key features in the clinical history and on cardiac imaging that should raise the suspicion of the different forms of cardiac amyloidosis. Top left, Apo AI cardiac amyloidosis can present with laryngeal involvement, multiorgan involvement, and a strong family history. Echocardiographic images demonstrate right-sided disease with thickening of the tricuspid valve and tricuspid regurgitation. Cardiac magnetic resonance (CMR) demonstrates right atrial and right ventricular thickening, and right atrial and right ventricular late gadolinium enhancement (LGE). Top right, Apo AIV cardiac amyloidosis has a male predominance and can present with renal involvement. Echocardiographic images demonstrate biventricular wall thickening and a typical apical-sparing strain pattern. CMR demonstrates left ventricular wall thickening, biventricular transmural LGE, and an elevated extracellular volume (ECV). Bottom left, Immunoglobulin light-chain (AL) cardiac amyloidosis can present with macroglossia, multisystem involvement, and nephrotic syndrome. Echocardiographic images demonstrate biventricular wall thickening. CMR demonstrates diffuse biventricular transmural LGE and an elevated ECV. Bottom right, Transthyretin (ATTR) cardiac amyloidosis has a male predominance and can present with polyneuropathy and a strong family history. Echocardiographic images demonstrate biventricular wall thickening. CMR demonstrates diffuse biventricular transmural LGE and an elevated ECV. hATTR indicates hereditary ATTR.