ABC Heart Fail Cardiomyop 2021; 1(2): 127-129
Cardiac Scintigraphy with Bone Markers in Clinical Practice: When to Solicit the Exam? How to Interpret the Results?
When to solicit cardiac scintigraphy with bone markers?
In view of the aspects mentioned above, it is important for investigation of the specific form of ATTR-CA, using bone marker scintigraphy, to begin after 2 key preliminary steps: 1. establishing high clinical suspicion of the presence of CA and 2. ruling out the presence of immunoglobulin light chains, which would lead us to diagnosis of AL-CA.
It is fundamental to establish high clinical suspicion, given that negative scintigraphy does not rule out the presence of CA in its various forms, particularly the AL form. In other words, in a significant percentage of cases with high clinical suspicion and negative scintigraphy, investigation should continue with tissue biopsy, including endomyocardial biopsy, in order to conclude diagnosis. It is clear that endomyocardial biopsy should only be performed in cases of high clinical suspicion, as it is an invasive method with risks that, although low, are inherent to the procedure.
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Keywords: Amyloidosis; Diagnostic Methods; Scintigraphy
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