Workup of Suspected Amyloidosis

Begin with a targeted search for "red flag" clinical features, followed by echocardiography to assess for increased left ventricular wall thickness (>12mm), then proceed with serum/urine monoclonal protein screening and cardiac bone scintigraphy (99mTc-PYP/DPD/HMDP) to establish diagnosis without biopsy in most ATTR cases, or tissue biopsy with Congo red staining and mass spectrometry typing for AL amyloidosis