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

Marco Luigetti, MD, PhD

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August 18, 2022

According to Roberts and colleagues, hATTR amyloidosis is typically fatal within 7-12 years from the onset of symptoms. Death is most often owing to cardiac dysfunction, infection or cachexia. In areas where hATTR amyloidosis is endemic, clinical onset often occurs before the age of 50 years (commonly before 40 years of age) and includes progressive sensorimotor and autonomic neuropathy. Cardiac, renal and ocular involvement is also common.

In nonendemic areas, as well as in endemic regions of Sweden, disease-related symptoms tend to begin in people ≥ 50 years of age. Symptoms involving sensory and motor neuropathy of the upper and lower extremities are typical and are associated with mild autonomic symptoms.

Editor's Note: Skill Checkups are wholly fictional or fictionalised clinical scenarios intended to provide evidence-based educational takeaways.

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