Avoiding Diagnostic Pitfalls in ATTR-CM: Getting the Diagnosis Right the First Time

Drs. Kittleson and Ghafourian discuss how to accurately diagnose ATTR-CM, emphasizing that the first step must always be a complete monoclonal protein screen to exclude AL amyloidosis before interpreting a PYP scan. They highlight common pitfalls with PYP imaging; the supportive (but not definitive) role of cardiac MRI; the need for routine TTR genotyping after diagnosis; and the importance of recognizing noncardiac clues to identify patients early enough to benefit from disease‑modifying therapies.