CLINICIAN GUIDE · CARDIOMYOPATHY & CARDIAC AMYLOIDOSIS · SECTION 3 OF 3
Connect subtype-specific treatment with cardiac and family care.
Dilated/reduced-EF disease often needs HF-directed therapy and reassessment. HCM treatment depends on symptoms, obstruction, arrhythmia risk, and patient goals; nuanced decisions belong with an experienced HCM team.
ICD decisions are disease specific. EF, scar, genetic findings, syncope, and family history may contribute; not every cardiomyopathy needs an ICD.
[1][3][6]AL: expedite hematology and an amyloidosis team for plasma-cell-directed treatment. Do not delay referral while waiting for every outpatient test.
ATTR-CM: specialist options include TTR stabilizers such as tafamidis or acoramidis and the TTR silencer vutrisiran. Eligibility, comorbidities, monitoring, access, and evidence guide selection.
[2][4][5]Diuretic treatment may help congestion, but BP and renal tolerance matter. Some conventional cardiac drugs are poorly tolerated in amyloidosis; avoid automatic escalation without reassessing symptoms and physiology.
Coordinate rhythm surveillance, AF stroke prevention, conduction-system assessment, and family counseling. Track symptoms, function, congestion, renal function, and response. Early referral matters: amyloid deposition and myocardial disease can progress before EF falls.
[1][2][6]Adult clinician education · References reviewed October 11, 2026.