Recurrent Syncope, a Clue in Amyloid Cardiomyopathy

Table 1

Type of amyloidosis	Amyloid composition	Organs involved	Symptoms	Prognosis	Other
AL amyloidosis	Immunoglobulin-derived light chain	Kidneys > heart, gastrointestinal tract, nervous system	Left and right heart failure, syncope, and autonomic neuropathy	Median survival 8–12 months	Plasma cell dyscrasia, requires treatment
ATTR-mt (familial)	Mutant transthyretin	Heart and nervous system	Heart failure can be severe, ±neuropathy	Varies depending on mutation, but favorable compared to AL	Autosomal dominant
ATTR-wt	Wild-type transthyretin	Heart	Less severe heart failure than AL or ATTRm	75 months	90% are men > 60 years old

AL = amyloid light chain; ATTR-mt = mutant transthyretin amyloidosis; ATTR-wt = wild-type transthyretin amyloidosis.