Sorry, hATTR amyloidosis is not the most likely diagnosis
Some of the signs are there; however, it’s more likely that this patient has hypertrophic cardiomyopathy. Although she presents with signs and symptoms that could be suggestive of hATTR amyloidosis, the lack of myocardial uptake of 99mTc-PYP suggests that she does not have hATTR amyloidosis. Radionuclide scintigraphy using technetium-labeled tracers has been shown to be >99% sensitive and 68% specific for cardiac ATTR amyloidosis.1
- Veselka J, Anavekar NS, Charron P. Lancet. 2017;389(10075):1253-1267.