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Vol. 224. Núm. 5.
Páginas 253-336 (Mayo 2024)
Artículo especial

Sospecha clínica, diagnóstico y seguimiento de la amiloidosis cardíaca: documento de actualización y resumen ejecutivo

Clinical suspicion, diagnosis and management of cardiac amyloidosis: update and executive summary
Visitas
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S. Yuna,b,c,d,
Autor para correspondencia
sergi.yun@bellvitgehospital.cat

Autor para correspondencia.
, J. Casadoe,f, J. Pérez-Silvestreg, P. Salamancah,i, P. Llàcerj,k, R. Quirósl,m, R. Ruiz-Huesoh, M. Méndezn, L. Manzanoj,k, F. Formigac,o
a Bio-Heart Cardiovascular Diseases Research Group, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, España
b Programa de Atención a la Insuficiencia Cardíaca Comunitaria, Servicios de Cardiología y Medicina Interna, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
c Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
d Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, España
e Servicio de Medicina Interna, Hospital Universitario de Getafe, Getafe, Madrid, España
f Universidad Europea de Madrid, Madrid, España
g Servicio de Medicina Interna, UMIPIC, Consorcio Hospital General Universitario de Valencia, Valencia, España
h Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España
i Departamento de Medicina, Universidad de Sevilla, Sevilla, España
j Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España
k Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, España
l Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España
m Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), España
n Servicio de Medicina Interna, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, España
o Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, España
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En los últimos años el interés en la amiloidosis cardíaca ha crecido exponencialmente. No obstante, es necesario mejorar en su conocimiento para optimizar los sistemas de detección precoz. Por lo tanto, es crucial incorporar instrumentos para mejorar la sospecha, el diagnóstico y el seguimiento de la amiloidosis cardíaca. En este sentido, diseñamos una herramienta siguiendo las distintas fases para alcanzar el diagnóstico de la amiloidosis cardíaca, así como un óptimo seguimiento: a) sospecha clínica, donde se pone en relieve la importancia de los «red flags» para sospecharla y activar el proceso diagnóstico; 2) diagnóstico, donde se desgrana principalmente el algoritmo diagnóstico; y 3) seguimiento de los pacientes confirmados. Se trata de una herramienta que será de gran utilidad para todos aquellos profesionales que atienden a pacientes con sospecha de amiloidosis cardíaca o enfermedad ya confirmada, para mejorar su detección precoz, así como optimizar su preciso diagnóstico y un óptimo seguimiento.

Palabras clave:
Amiloidosis cardíaca
Insuficiencia cardíaca
Red flags
Sospecha clínica
Diagnóstico precoz
Abstract

In recent years, the interest in cardiac amyloidosis has grown exponentially. However, there is a need to improve our understanding of amyloidosis in order to optimise early detection systems. Therefore, it is crucial to incorporate solutions to improve the suspicion, diagnosis and follow-up of cardiac amyloidosis. In this sense, we designed a tool following the different phases to reach the diagnosis of cardiac amyloidosis, as well as an optimal follow-up: a) clinical suspicion, where the importance of the “red flags” to suspect it and activate the diagnostic process is highlighted; 2) diagnosis, where the diagnostic algorithm is mainly outlined; and 3) follow-up of confirmed patients. This is a practical resource that will be of great use to all professionals caring for patients with suspected or confirmed cardiac amyloidosis, to improve its early detection, as well as to optimise its accurate diagnosis and optimal follow-up.

Keywords:
Cardiac amyloidosis
Heart failure
Red flags
Clinical suspicion
Early diagnosis

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