• Understanding amyloidosis
  • Treatment and care with ATTR-CM
  • Living with ATTR-CM
  • Supporting someone with ATTR-CM
  • Further support
Section 2 banner

Early warning signs of ATTR-CM

There are a number of signs and symptoms that can be associated with ATTR-CM. It can be helpful for you to be aware of these in your daily life so that you can discuss them with your doctor. Understanding the symptoms that you are experiencing will help them ask important questions and plan tests to confirm a diagnosis as soon as possible.

Doctors may use the term red flags to describe early warning signs and symptoms of diseases. There are several red flags that may suggest you have transthyretin amyloid cardiomyopathy (ATTR-CM), or that you are at risk of developing it in the future.

If you have one or more of these red flags, it does not always mean you have ATTR-CM. However, your doctor may want to take a closer look and arrange for more tests, so that if you do have the condition, you can get a diagnosis and start treatment as soon as possible.

What are the red flags for ATTR-CM?

  • Age: ATTR-CM is most common in people over the age of 60
  • Heart failure: If you develop heart failure (a condition where, over time, the heart becomes less effective in helping blood move properly through the body)
  • Family history: If you have relatives who have variant-type ATTR-CM (vATTR-CM, which is the type that runs in families), other heart conditions, or nerve damage (neuropathy), you may be at high risk of having ATTR-CM. If this is the case, a genetic test can check whether you carry the inherited gene change
  • Other health conditions: Some health problems that may not seem related to the heart can be early warning signs for ATTR-CM. These include:
    • Carpal tunnel syndrome: Numbness, tingling, or pain in your hands and arms caused by a squeezed nerve in the wrist
    • Biceps tendon rupture: A tear in the tendon that connects your upper arm muscle (biceps) to your shoulder or elbow
    • Lumbar spinal stenosis: A narrowing in the lower spine that can cause back pain, leg pain, or difficulty walking

Your doctor may also spot early warning signs of ATTR-CM in a routine heart check, such as:

  • Thickened heart walls (seen on a scan)
  • Weak or abnormal electrical signals (seen on an electrocardiogram [ECG])

If these signs are found and you are at risk of ATTR-CM, your doctor will recommend more tests.

To learn more about the tests that help to diagnose ATTR-CM, see the next page.
 

To explore topics in other sections, click on the links below:

    • 1
      Izumiya Y, et al. ESC Heart Failure. 2025;12(2):955–967.
    • 2
      Patel KS, Hawkins PN. J Intern Med. 2015;278:126-144.
    • 3
      World Heart Federation. Living With Transthyretin Amyloid Cardiomyopathy: A Toolkit for Patients. Available at: www.world-heart-federation.org/wp-content/uploads/WHF_ATTR-Tool-Kit.pdf (Last accessed: March 2026).
    • 4
      Law S, Gillmore JD. Am J Med. 2022;135 Suppl 1:S2-S8.
    • 5
      Ruberg FL, et al. J Am Coll Cardiol. 2019;73(22):2872-2891.
    • 6
      Cleveland Clinic. Carpal Tunnel Syndrome. Available at: www.my.clevelandclinic.org/health/diseases/4005-carpal-tunnel-syndrome (Last accessed: March 2026).
    • 7
      Cleveland Clinic. Bicep Tendonitis. Available at: www.my.clevelandclinic.org/health/diseases/bicep-tendonitis (Last accessed: March 2026).
    • 8
      Cleveland Clinic. Spinal Stenosis. Available at: www.my.clevelandclinic.org/health/diseases/17499-spinal-stenosis (Last accessed: March 2026).
    • 9
      Porcari A, et al. Eur J Intern Med. 2024;123:29-36.