Diagnostic and Treatment Algorithm for Amyloidosis

When cardiac amyloidosis is suspected based on clinical features, immediately screen for plasma cell dyscrasia with serum and urine protein electrophoresis with immunofixation plus serum free light chain assay, then proceed with cardiac imaging and nuclear scintigraphy to differentiate AL from ATTR subtypes, as this distinction fundamentally determines whether the patient requires urgent hematology referral for chemotherapy (AL) versus targeted ATTR therapy.