Cardiac MRI Revealed Amyloidosis After Scan Failed
A new case report shows why specialized imaging was required to identify heart failure markers in a 74-year-old man.
Updated on Oct. 9, 2026 in Heart Disease
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In September 2026, clinicians at Allegheny General Hospital reported a case where a cardiac MRI successfully identified localized amyloidosis that a standard nuclear scan missed. This diagnostic challenge occurred in a 74-year-old patient who ultimately received a diagnosis of wild-type ATTR-CM.
Why it matters
False negatives on initial nuclear scans can delay treatment for amyloidosis because early deposits of amyloid protein are often patchy rather than diffuse. Identifying these patterns early is critical for managing symptoms like heart failure, atrial fibrillation, and bilateral carpal tunnel syndrome.
A case report published in JACC: Case Reports detailed a 74-year-old man who initially tested negative for amyloidosis before cardiac MRI revealed localized thickening and elevated extracellular volume. A follow-up 3D nuclear scan confirmed grade 2 tracer uptake, leading to his ATTR-CM diagnosis.
The players
Allegheny General Hospital
A medical facility in Pittsburgh where the clinical diagnosis and subsequent case study were conducted.
JACC: Case Reports
A peer-reviewed journal that publishes medical findings and clinical investigations.
The details
Cardiac amyloidosis involves the buildup of misfolded proteins in the heart tissue, which increases muscle wall thickness and stiffens the organ. In this patient, the MRI detected a 19-millimeter thick ring of tissue at the base of the left ventricle that had avoided detection by standard 2D scans. By utilizing 3D nuclear imaging, doctors confirmed tracer uptake in this specific region, allowing for an accurate diagnosis and subsequent treatment.
Timeline
2019: The FDA approved tafamidis for cardiac amyloidosis.
2024: The FDA approved acoramidis for ATTR-CM.
2025: The FDA approved vutrisiran for ATTR-CM.
September 2026: The case report was published in JACC: Case Reports.
Health Landscape
The diagnosis of wild-type ATTR-CM has evolved significantly as clinicians move beyond the patient cohorts defined by the ATTRibute-CM trial. This case reflects the ongoing push to utilize high-resolution imaging to detect early-stage disease manifestations that standard screening might miss.
If you are managing unexplained heart failure, atrial fibrillation, or chronic carpal tunnel syndrome, discuss the possibility of amyloidosis with your cardiologist. These symptoms combined may warrant further investigation beyond standard nuclear scans, such as a specialized cardiac MRI.
The takeaway
Cardiac amyloidosis can present with localized deposits that are difficult to detect during standard initial screenings. If you have multiple risk factors, consult your doctor about the potential utility of advanced cardiac imaging techniques like 3D nuclear scans or MRI.
Further reading
For more information on diagnostic advancements, visit the Heart Disease section.
Source note: This article includes information reported by Medical Daily.
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