The goals of treatment for ATTRwt are:
- To try and reduce the production of the amyloid forming TTR protein or to interfere with the misfolding process and therefore stop the amyloid depositing into the organs and tissues.
- To support and preserve the affected organs.
- To improve the patient’s quality of life.
Chemotherapy has no role in ATTRwt.
Symptomatic and supportive treatments remain the mainstay of treatment.
Treatments are focused on controlling the symptoms of heart failure and will be recommended and monitored for the needs of the individual patient by the cardiologist and other specialists on the amyloidosis treatment team.
Some of these treatments may be:
- Fluid balance. Avoiding excess fluid. (keeping a diary on daily weight)
- Diuretics (water tablets) to get rid of excess fluid and thus reduce symptoms of breathlessness and swelling of the ankles and legs (oedema)
- Salt restriction
- Anticoagulation medication (thinning the blood)
- A pacemaker may be suggested if there is a slow or irregular heart beat
- Heart transplantation is rarely recommended except in highly selected younger patients
- Reviewing diet. A dietician may be of help.
- Exercise within limits.