Cardiology is the medical specialty focused on the heart and the cardiovascular system. It involves the diagnosis, treatment, and prevention of conditions affecting the heart and blood vessels. These conditions include coronary artery disease, heart failure, arrhythmias (irregular heartbeats), and valve disorders. The field covers a broad spectrum, from congenital heart defects present at birth to acquired conditions like heart attacks.
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Recognizing the signs of cardiac amyloidosis can be challenging because they often overlap with other common conditions. Many people attribute their symptoms to getting older or being out of shape. The symptoms usually develop slowly over time, which can make it hard to pinpoint exactly when they started. The hallmark of this condition is that it affects more than just the heart. Because the amyloid proteins travel through the bloodstream, they can deposit in other parts of the body, creating a constellation of symptoms that might seem unrelated at first glance.
For example, a person might experience numbness in their hands years before they notice any trouble with their breathing. Or they might have trouble with their digestion that they assume is just a sensitive stomach. When doctors look at the whole picture, these seemingly separate issues form a clear pattern. Understanding these symptoms empowers you to describe what you are feeling to your healthcare team, ensuring that nothing is overlooked. It is all about connecting the dots between what is happening in the heart and what is happening in the rest of the body.
The most noticeable symptoms of cardiac amyloidosis are related to fluid retention. Because the stiff heart cannot pump blood efficiently, fluid backs up into the tissues. This is not just about gaining a few pounds; it is a physical change that affects how you move and feel. You might notice that your shoes feel tight in the evening or that your socks leave deep indentations on your ankles.
This fluid buildup can also occur in the abdomen, making you feel full or bloated even when you haven’t eaten much. Some people report a loss of appetite because of this feeling of fullness. The fluid can also settle in the lungs, which leads to the breathing difficulties many patients experience. It is important to pay attention to these physical changes, as they are often the first clue that the heart is struggling to handle the body’s fluid balance.
The most common physical sign is swelling in the lower legs, ankles, and feet. This is called edema. It happens because gravity pulls fluid down, and the heart isn’t pumping strongly enough to circulate it back up effectively. You might find that the swelling is better in the morning after lying flat all night but gets worse as the day goes on. Elevating your legs can help, but it doesn’t solve the underlying problem.
Breathlessness is another key symptom. At first, you might only notice it when you are active, like when walking up a hill or carrying groceries. As the condition progresses, you might feel short of breath even when lying flat. Many people find they need to prop themselves up with extra pillows to sleep comfortably. This happens because fluid accumulates in the lungs when you lie down, making it harder to breathe.
Feeling tired is a very common complaint, but the fatigue associated with cardiac amyloidosis is often more intense than normal tiredness. It is not just about being sleepy; it is a lack of energy to do basic tasks. You might wake up feeling rested but feel exhausted after taking a shower or getting dressed. This happens because the heart cannot pump enough oxygen-rich blood to the muscles to fuel their activity.
This fatigue can vary from day to day. Some days you might feel capable of doing your normal routine, while other days you might feel like you are moving through water. It is important to listen to your body and not push through this fatigue. It is a signal that your body needs rest. Patients often describe a “heavy” feeling in their limbs, making movement feel like a chore.
One of the most distinctive aspects of cardiac amyloidosis is its connection to the nervous system. The same amyloid deposits that stiffen the heart can also build up in the nerves. This can cause a range of sensations and functional problems. These nerve symptoms often appear years before the heart symptoms become obvious. Recognizing this link is often the key to an early diagnosis.
Neuropathy, or nerve damage, can affect the nerves that control sensation and movement in the hands and feet. It can also affect the autonomic nerves that control automatic body functions like blood pressure and digestion. If you have a history of nerve issues, it is crucial to mention this to your cardiologist. It provides a vital clue that links your heart condition to a systemic cause
Carpal tunnel syndrome is a condition where the nerve in the wrist gets compressed, causing pain and numbness in the hand. In cardiac amyloidosis, amyloid deposits thicken the ligament in the wrist, squeezing the nerve. It is very common for patients to have surgery for carpal tunnel syndrome in both hands five to ten years before heart failure develops. If you have had this surgery, especially on both sides, it is a significant risk marker.
Peripheral neuropathy involves damage to the nerves in the extremities. You might feel tingling, burning, or numbness in your toes and feet. This sensation can slowly spread up the legs. It can make it difficult to feel where you are stepping, affecting your balance. This is distinct from the pain of arthritis; it is often described as a “pins and needles” sensation that doesn’t go away.
The autonomic nervous system, which controls digestion, can also be affected by amyloid deposits. This can lead to a variety of gastrointestinal issues. Some people cycle between constipation and diarrhea without any clear dietary cause. Others might experience nausea or a feeling of getting full very quickly after starting a meal. This is because the stomach is emptying more slowly than it should.
Another sign related to the autonomic nervous system is dizziness when standing up. This happens because the blood vessels fail to constrict properly when you change position, causing a temporary drop in blood pressure. You might feel lightheaded or see spots when you get out of bed or stand up from a chair. These symptoms can be subtle but are important pieces of the diagnostic puzzle.
The electrical system of the heart runs through the heart muscle. When amyloid deposits build up in the muscle, they can disrupt these electrical pathways. This can lead to irregular heartbeats, known as arrhythmias. Atrial fibrillation is the most common rhythm issue seen in cardiac amyloidosis. It causes the upper chambers of the heart to quiver instead of beating effectively.
You might feel palpitations, a fluttering sensation in your chest, or a feeling that your heart is skipping a beat. Sometimes the heart rate can be too slow because the electrical signals are being blocked. If the heart rate becomes too slow, it can cause fainting spells or extreme dizziness. These rhythm issues can contribute to the formation of blood clots, so they need to be managed carefully.
As the condition progresses, the symptoms can become more constant. The swelling may move up into the thighs and abdomen. The shortness of breath may happen with very little activity, like walking from one room to another. You might notice substantial weight loss despite fluid retention, as the body loses muscle mass. This is often called cardiac cachexia.
It is also common to see bruising around the eyes, sometimes called “raccoon eyes.” This is rare but specific to AL amyloidosis. It happens because the tiny blood vessels become fragile due to amyloid deposits. Recognizing these advanced signs helps in adjusting the treatment plan to focus on comfort and symptom management.
Send us all your questions or requests, and our expert team will assist you.
The same protein that builds up in your heart can build up in the ligaments of your wrist. This thickening compresses the nerve in your wrist. It is often an early warning sign of the condition.
Amyloid deposits can affect the nerves that control your blood pressure. When you stand, your blood pressure might drop suddenly instead of adjusting. This drop causes the dizzy feeling.
Shortness of breath can be caused by many things, but in this context, it usually means fluid is building up in the lungs. It is a sign that the stiff heart is causing back-pressure in the lung’s blood vessels.
Some symptoms can improve significantly with treatment. Diuretics can help remove fluid and reduce swelling. However, nerve damage is often permanent, though medication can help manage the pain.
Many people with heart failure actually have cardiac amyloidosis. This is when bad proteins build up in the heart, causing damage. Is it heart disease?
Many people with heart failure actually have cardiac amyloidosis. This is when bad proteins build up in the heart, causing damage. Is it heart disease?
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