Skill Checkup: A 68-Year-Old Man With Acute Decompensated Heart Failure, Worsening Dyspnoea and Lower Extremity Oedema

Marco Luigetti, MD, PhD


August 18, 2022

About one half of patients with hATTR-CM have a history of carpal tunnel syndrome, according to Fosbøl et al. The two may be linked by systemic amyloid accumulation. Carpal tunnel syndrome frequently precedes the systemic manifestation and diagnosis of hATTR amyloidosis by several years.

Most patients with carpal tunnel syndrome preceding hATTR diagnosis have other systemic features, such as orthostatic hypotension, diarrhoea and constipation, erectile dysfunction, exercise intolerance and burning pain in the feet. Recognising systemic features of hATTR at the time of carpal tunnel syndrome diagnosis may improve early diagnosis of hATTR. Early diagnosis is particularly important in an era of new advances in hATTR-CM treatment, which are more effective when given earlier in the disease process.


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