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For asymptomatic gene carriers, echocardiography and 99mTc-PYP Scan were rated as Appropriate while CMR was rated as May Be Appropriate ECV has the potential to identify disease earlier in asymptomatic gene carriers compared with echocardiography In patients with suspicion for cardiac AL amyloidosis (biopsy-proven systemic AL amyloidosis or MGUS w/abnormal FLC levels) 99mTc-PYP was rated as Rarely Appropriate For patients with new symptomatic heart failure or those who are ATTR gene carriers/patients with AL or ATTR amyloidosis with new or worsening cardiac symptoms (chest pain, fatigue, effort intolerance, dyspnea, palpitations, dizziness/lightheadedness, syncope, orthopnea, PND, bloating, leg swelling, leg or jaw claudication) in which we are screening for cardiac amyloidosis, echocardiography, CMR, and 99mTc-PYP were rated as Appropriate Again, for patients suspicion for cardiac AL amyloidosis (biopsy-proven systemic AL amyloidosis or MGUS w/abnormal FLC levels) 99mTc-PYP was rated as Rarely Appropriate apart from the rare instance in long-term survivors of AL amyloidosis where concurrent ATTR cardiac amyloidosis is suspected For patients with biopsy-proven AL and ATTR cardiac amyloidosis, CMR and echocardiography were rated as Appropriate for assessing amyloid burden, response to therapy, or eligibility for stem cell transplant

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Heat therapy, such as a warm bath or heating pad, helps relax tight muscles and improve blood flow