Role of Multimodality Imaging in the Diagnostic work-up for Cardiac Amyloidosis

Cardiac amyloidosis is caused by the deposition of transthyretin or light-chain fibrils into the myocardium, leading to restrictive cardiomyopathy, and eventually death if untreated. The improvement in diagnostic modalities has seen a recent surge in the number of patients being diagnosed with cardiac amyloidosis, particularly transthyretin amyloidosis. The diagnostic workup often starts with echocardiogram, followed by cardiac magnetic resonance and finally pyrophosphate scintigraphy. It is important to know that while transthyretin amyloidosis is often diagnosed non-invasively with technetium pyrophosphate scan in the contemporary practice, the diagnosis of light-chain amyloidosis still needs tissue confirmation.