Kardiale Amyloidose – wichtige Differenzialdiagnose bei Herzinsuffizienz

Die Systemerkrankung Amyloidose entsteht durch Ablagerung fehlgefalteter Proteine und kann, je nach Organbeteiligung, sehr unterschiedliche Symptome verursachen. Dieser Beitrag zeigt auf, welche Befunde und Symptomkomplexe an eine Amyloidose denken lassen sollten und wie man zielgerichtet zur richtigen Diagnose kommt. Kausale Therapieoptionen wie auch Besonderheiten der Herzinsuffizienz-Therapie in diesem Patientenkollektiv werden erläutert.

Abstract

The systemic disease amyloidosis is caused by deposits of misfolded proteins and can cause very different symptoms depending on the organ involvement. The two most common forms are AL amyloidosis and ATTR amyloidosis. The determination of light chains and bone scintigraphy have a high priority in the diagnostic algorithm. New, causally effective substance classes are available for the therapy of AL and ATTR amyloidosis. The classic heart failure medication is often not well tolerated by patients with cardiac amyloidosis and must be adjusted in the presence of symptoms. This article shows which findings and symptom complexes should make you think of amyloidosis and how to arrive at the correct diagnosis in a targeted manner. Causal therapy options as well as special features of heart failure therapy in this patient collective are explained.

Schlüsselwörter

kardiale Amyloidose - AL - ATTR - AA-Amyloidose - Apolipoprotein - Herzinsuffizienz

Key words

cardiac amyloidosis - AL - ATTR - AA amyloidosis - apolipoprotein - heart failure

Publication History

Article published online:
16 November 2022

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