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Suspecting ATTR-CM

Resources to support recognition of the 'red flags'

Transthyretin amyloid cardiomyopathy (ATTR-CM) is frequently misdiagnosed as more common conditions, contributing to significant delays in appropriate treatment. Studies suggest that ATTR-CM may be a common yet undiagnosed cause of heart failure with preserved ejection fraction (HFpEF), affecting up to 11% of HFpEF patients. Despite the existence of well-documented red flags, these indicators remain underused in clinical practice — and patients continue to wait years for a definitive diagnosis.

 

Key red flags that may indicate ATTR-CM include:

  • Bilateral carpal tunnel syndrome
  • Lumbar spinal stenosis
  • Biceps tendon rupture
  • Low QRS voltage
  • Aortic stenosis

 

These signs are particularly significant when accompanied by increased left ventricular wall thickness. The earlier the recognition of ATTR-CM, the sooner patients can access the care they need.

Practical Resources for Clinical Practice

To assist healthcare professionals in identifying these critical signs, we have developed two practical resources:

Clinical Indicators and Diagnostic Pathways Thumbnail

Clinical Indicators and Diagnostic Pathways

A clear, concise overview of the cardiac and extracardiac red flags that should raise your index of suspicion for ATTR-CM, and an overview of the tests required for diagnosis.

Download Here
Red Flags Checklist Thumbnail

Red Flags Checklist

A simple, practical tool to help you systematically identify and record red flags in your patients — so you can quantify clinical suspicion and act with confidence.

Download Here

Prescribing information for BEYONTTRA®▼ (acoramidis) can be found here.

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Prescribing information for BEYONTTRA®▼ (acoramidis) can be found here.

 

Abbreviation:

ATTR-CM, Transthyretin Amyloid Cardiomyopathy.

 

PP-BEY-GB-0243 | April 2026

    • 1
      Rozenbaum MH, Large S, Bhambri R, Stewart M, Whelan J, van Doornewaard A, Dasgupta N, Masri A, Nativi-Nicolau J. Impact of delayed diagnosis and misdiagnosis for patients with transthyretin amyloid cardiomyopathy (ATTR-CM): a targeted literature review. Cardiol Ther. 2021;10(1):141–159.
    • 2
      Magdi M, et al. Transthyretin amyloidosis in heart failure with preserved ejection fraction. Am J Cardiovasc Dis. 2022;12(3):102–111.
    • 3
      Achten A, van Empel VPM, Weerts J, et al. Changes in the diagnostic trajectory of transthyretin cardiac amyloidosis over six years. Heart Vessels. 2024;39(10):857–866.
    • 4
      Garcia-Pavia P, Rapezzi C, Adler Y, et al. Diagnosis and treatment of cardiac amyloidosis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur J Heart Fail. 2021;23(4):512–526.