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The objective of this review is to increase awareness and diagnosis of ATTR amyloidosis by improving recognition of its overlapping conditions, misdiagnosis, and multiorgan presentation. Cardiac manifestations include heart failure, atrial fibrillation, intolerance to previously prescribed antihypertensives, sinus node dysfunction, and atrioventricular block, resulting in the need for permanent pacing. Neurologic manifestations include progressive sensorimotor neuropathy (e.g., pain, weakness) and autonomic dysfunction (e.g., erectile dysfunction, chronic diarrhea, orthostatic hypotension). Non-cardiac red flags often precede the diagnosis of ATTR amyloidosis and include musculoskeletal manifestations (e.g., carpal tunnel syndrome, lumbar spinal stenosis, spontaneous rupture of the distal tendon biceps, shoulder and knee surgery). Awareness and recognition of the constellation of symptoms, including cardiac, neurologic, and musculoskeletal manifestations, will help with early diagnosis of ATTR amyloidosis and faster access to therapies, thereby slowing the progression of this debilitating disease.<\/jats:p>","DOI":"10.1007\/s10741-021-10080-2","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T12:09:55Z","timestamp":1613822995000},"page":"785-793","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":116,"title":["Screening for ATTR amyloidosis in the clinic: overlapping disorders, misdiagnosis, and multiorgan awareness"],"prefix":"10.1007","volume":"27","author":[{"given":"Jose N.","family":"Nativi-Nicolau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chafic","family":"Karam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Khella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew S.","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,20]]},"reference":[{"key":"10080_CR1","doi-asserted-by":"publisher","first-page":"4499","DOI":"10.1073\/pnas.75.9.4499","volume":"75","author":"PP Costa","year":"1978","unstructured":"Costa PP, Figueira AS, Bravo FR (1978) Amyloid fibril protein related to prealbumin in familial amyloidotic polyneuropathy. 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Nativi-Nicolau reports funding for clinical trials from Pfizer, Akcea Therapeutics, and Eidos; educational grants from Pfizer; and consulting fees from Pfizer, Eidos, Akcea Therapeutics, and Alnylam. Chafic Karam reports consulting\/educational activities for Akcea Therapeutics, Alexion, Alnylam, Argenx, Biogen, CSL Behring, Medscape, and Sanofi Genzyme; and has received research grants from Sanofi Genzyme and Akcea Therapeutics. Sami Khella reports honoraria from Akcea Therapeutics and Alnylam. Mathew S. Maurer reports grants from Pfizer and Alnylam; and personal fees from Pfizer, Eidos, GlaxoSmithKline, Prothena, Akcea Therapeutics, and Ionis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}