Module 2 Lesson 4 (Step 1 – The Voltage Clue: Electrocardiographic Red Flags for Suspecting ATTR-CM)

This lesson delves into one of the most accessible yet underutilized diagnostic tools in cardiac amyloidosis, the electrocardiogram (ECG). During Step 1 of the ATTR-CM diagnostic algorithm, the ECG offers subtle but critical clues that can prompt further investigation. Findings such as low QRS voltage, pseudo-infarct patterns, conduction delays, and atrial fibrillation help distinguish ATTR-CM from more common cardiac pathologies like hypertensive heart disease or hypertrophic cardiomyopathy. This lesson guides clinicians in interpreting these patterns and underscores the importance of the voltage-to-mass mismatch, a hallmark feature of amyloid infiltration. Learners will also explore how emerging AI-enabled ECG tools enhance early recognition.