ATTR-CM Heart Attack Symptoms
Unlike a typical heart attack that’s often caused by blocked arteries, a heart attack due to ATTR-CM (transthyretin amyloid cardiomyopathy) results from the heart's inability to pump effectively because of stiff, amyloid-filled heart walls. The symptoms can be subtle at first, but they become more serious over time. Let’s break down the warning signs of a heart attack that may be related to ATTR-CM, and what treatments are available if you or someone you love is diagnosed.
1. Shortness of Breath
One of the most common early symptoms of ATTR-CM is shortness of breath, especially during physical activity or even when lying down. This happens because the heart can’t pump blood efficiently, leading to fluid buildup in the lungs. You may feel winded climbing stairs or find it hard to breathe while lying flat. You might need extra pillows to sleep comfortably.
2. Fatigue and Weakness
As the heart becomes less effective, your muscles and organs receive less oxygen, causing fatigue and reduced stamina. People with ATTR-CM often feel unusually tired even after mild activity. Daily tasks like walking to the mailbox or carrying groceries may suddenly feel exhausting.
3. Swelling in the Legs, Ankles or Abdomen
Heart failure caused by ATTR-CM can lead to fluid retention in the lower body, causing swelling (edema). Shoes may feel tighter than usual, and you may notice puffiness around the ankles or lower legs. Swelling in the abdomen (bloating) can also occur.
4. Irregular Heartbeat or Palpitations
Amyloid buildup in the heart can interfere with electrical signals, leading to arrhythmias (irregular heart rhythms). You may feel your heart racing, fluttering or skipping beats. Dizziness or fainting can also occur if the heartbeat becomes too slow or erratic.
5. Chest Pain or Pressure
Though less common in ATTR-CM than in classic heart attacks, chest discomfort can still occur due to reduced blood flow and increased heart strain. You may experience a feeling of pressure, tightness or mild pain in the chest, especially during exertion or emotional stress.
6. Numbness or Tingling in Hands and Feet
Some people with hereditary ATTR-CM may also develop nerve-related symptoms like tingling, numbness or burning in the hands and feet, known as peripheral neuropathy. This can feel like a sensation of pins and needles, often starting in the toes or fingertips and progressing over time.
7. Carpal Tunnel Syndrome (Especially in Both Hands)
Unexplained carpal tunnel syndrome in both wrists—especially in men over 60—can be an early red flag for ATTR-CM. Pay attention to any wrist pain, numbness or hand weakness that doesn’t improve with standard treatment.
Treatment Options for ATTR-CM
While there’s currently no cure for ATTR-CM, treatment options can slow progression, relieve symptoms and improve quality of life. The earlier it’s diagnosed, the better the outcomes.
1. Medications to Stabilize Amyloid Production
Tafamidis (Vyndaqel or Vyndamax) is an FDA-approved medication that helps stabilize the transthyretin protein, slowing the formation of amyloid deposits. It’s been shown to reduce the risk of death and hospitalization in patients with ATTR-CM.
2. Supportive Treatments for Heart Failure
Standard heart failure treatments—like diuretics (water pills), beta-blockers and ACE inhibitors—may help relieve symptoms. However, not all heart medications are well tolerated in ATTR-CM, so treatment must be personalized.
3. Lifestyle Changes
Managing salt intake, staying active within comfort levels and monitoring fluid retention are all essential. Patients are often advised to follow a low-sodium diet and avoid excessive fluid intake to prevent worsening heart failure symptoms.
4. Treatment for Arrhythmias
Some patients may need a pacemaker or implantable cardioverter defibrillator (ICD) to manage irregular heartbeats. Regular monitoring by a cardiologist is essential.
5. Genetic Counseling and Testing (for Hereditary ATTR-CM)
If hereditary ATTR-CM is suspected, genetic testing can confirm the diagnosis. Family members may also benefit from screening and early intervention.
Final Thoughts
ATTR-CM is a serious, progressive condition that often flies under the radar, but it doesn’t have to. Understanding the warning signs, especially in older adults, and seeking early medical attention can lead to better outcomes. If you or a loved one has unexplained heart symptoms—particularly in combination with signs like carpal tunnel, neuropathy or swelling—it’s worth asking your doctor about testing for ATTR-CM. With growing awareness and new treatments, patients today have more hope than ever.
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