Timely Intervention in Light Chain Cardiac Amyloidosis

BACKGROUND: Light-chain cardiac amyloidosis (AL-CA) is often overlooked and misdiagnosed as simple diastolic dysfunction, which can lead to worse outcomes if an accurate diagnosis is delayed. CASE SUMMARY: This case highlights the importance of utilizing a multidisciplinary team approach and multimodality imaging, such as cardiac magnetic resonance and endomyocardial biopsy, in the prompt diagnosis and treatment of AL-CA with a tailored hematologic treatment regimen in a 70-year-old male. Patient achieved complete remission with Dara-CyBorD (daratumumab, cyclophosphamide, bortezomib, and dexamethasone) therapy in 5 months, demonstrating stabilization and potential reversal of myocardial dysfunction. DISCUSSION: Of the many causes of heart failure with preserved ejection fraction, AL-CA can have an especially poor prognosis if diagnosis is delayed. It is crucial to be aware of the clinical presentation of AL-CA, the wide variety of diagnostic tools, multidisciplinary management, and intensive treatment options available, and importance of regular follow-up. TAKE-HOME MESSAGES: Recognizing the hallmark diagnostic features of AL-CA is crucial for differentiating it from other causes of diastolic dysfunction, particularly in the early work-up period. Timely diagnosis of AL-CA and assessment of the infiltrative burden are essential for selecting an individualized hematologic treatment course.