Cardiac Amyloidosis: Heart Attack Caused By Protein!

By Dr. (Prof.) Purshotam Lal in Cardiology

Sep 4, 2020

We are all aware of the proteins as they are part of our daily nutrition and also as they are building blocks of our body essential for muscle growth etc.  What if you come to know that a type of protein can cause a heart attack? You will panic and start questioning your dietary habits.

However, the protein in question here is not the normal protein and it is also not found in your food. Amyloid is an abnormal protein that builds up in your organs and disrupts the normal functioning of affected organs. As said it is not found in our food or body, however, it can form as a result of the combination of several proteins present in our body.

Cardiac Amyloidosis is a condition when Amyloid deposit builds up in the heart tissues and causes hindrance in the normal heart functions. It can become so severe that even heart transplants become necessary.  

There are many types of amyloidosis, when amyloid deposits form in between the cells of heart muscle it is known as Cardiac amyloidosis (“stiff heart syndrome”) and it is a type of restrictive cardiomyopathy. When amyloidosis affects the electrical pulses in the heart it can lead to arrhythmias. Sometimes the Cardiac amyloidosis can be inherited and is categorized as familial cardiac amyloidosis.

Cardiac Amyloidosis can sometimes be associated as co-effects of other diseases and this condition usually subsides with the treatment of the core disease. This condition can affect anyone, however, the prevalence of the disease is less in people under the age of 40.

 Causes of Cardiac Amyloidosis are uncertain as of now, we can only tell how it affects the organs by studying the affected tissues. These are normal Amyloid are normal proteins, they do not mutate or transform into something else, they just become insoluble and form deposits in various organ muscles leading to Amyloidosis.

Symptoms of Cardiac Amyloidosis

Symptoms of Cardiac Amyloidosis may be subtle or may not present at all. Following are some signs of Amyloidosis

• Frequent night urination
• Fatigue, Reduced physical ability
• Swelling in abdomen, legs, ankles, etc.
• Breathing problems when lying down
• Lung crackles or heart murmur
• Drop-in Blood pressure while standing up
• Enlarged neck veins
• Swollen liver
• Palpitations
• Shortness of breath
• Excessive weight (fluid) gain
• Excessive weight loss
• Fainting spells

These signs are similar to many other conditions and this can make cardiac amyloidosis hard to diagnose. It requires biopsy of affected tissues to ascertain the condition, many times based on symptoms alone, this condition can be misdiagnosed. So it is essential to contact an experienced cardiologist who has encountered such cases so they may look at these symptoms from every angle. Department of Cardiology, Metro Group of Hospitals has a great team of cardiologists with vast experience, who can handle such cases with excellent patient outcomes.

Cardiac Amyloidosis Diagnosis

As we have mentioned, a thorough examination is required to ascertain the Cardiac Amyloidosis, so in case a cardiologist suspects that the patient is suffering from the Amyloidosis, they may recommend the following tests:

• MRI
• PET
• Nuclear heart scans (MUGA, RNV)-
• Chest or abdomen CT scan
• Coronary angiography
• Electrocardiogram (ECG)
• Echocardiogram

If the above test shows the signs of Cardiac Amyloidosis, a cardiac biopsy is done to confirm the condition. It entails the collection of tissue samples using Biopsy Catheterfrom the affected organ, in this case, the heart and is studied in the laboratory to estimate the extent of the incursion.

Cardiac Amyloidosis Treatment

Type of treatment depends upon the type of Cardiac Amyloidosis.  Amyloids cannot be removed from the affected organs using either surgery or medications. So the treatment is focused on stopping the Amyloid protein from being produced or stabilizing the protein.  This may entail making diet changes and cardiologists may ask you to limit intake of salt and fluids.

Diuretics May be recommended to remove excess fluid. Medicines such as digoxin, calcium-channel blockers, and beta-blockers may be recommended for people with atrial fibrillation. However, People with cardiac amyloidosis may be extra sensitive to the side effects of these drugs, so extra caution is required.

People should note that in a certain type of Cardiac Amyloidosis normal heart attack medicines might cause severe side effects, so it is necessary to consult cardiologists who have ample experience in dealing with such cases.

Other treatments that can be considered for Cardiac Amyloidosis are:

• Chemotherapy
• Implantable cardioverter-defibrillator (AICD)
• Pacemaker,( if the patient is suffering from arrhythmia)
• Prednisone, an anti-inflammatory medicine

In cases where damage to the heart is irreversible, a heart transplant is the only option. If the patient is suffering from Familial hereditary amyloidosis, where the liver is producing such protein, a liver transplant becomes necessary. 

Metro Group of Hospitals has multi-specialty departments that can work in cohesion to provide specialized care required for such treatments. 

Earlier, cardiac amyloidosis was considered untreatable, however, with rapid development in the field of medicine and willingness to try experimental procedures have led to various breakthrough in cardiac amyloidosis treatment. Again as emphasized earlier, cardiac amyloidosis is a complicated condition and it requires experienced and specialized care and if misdiagnosed as a normal heart condition, it can lead to severe consequences. In case you or your loved ones experience symptoms of cardiac amyloidosis or any other heart problems, we are here to guide you through our years of experience.

We at metro hospitals are always with you!