{"id":4499,"date":"2023-06-14T08:00:00","date_gmt":"2023-06-14T06:00:00","guid":{"rendered":"https:\/\/www.amyloidosisalliance.org\/lamiloidosi-cardiaca-e-sottodiagnosticata\/"},"modified":"2026-11-03T10:28:16","modified_gmt":"2026-11-03T09:28:16","slug":"lamiloidosi-cardiaca-e-sottodiagnosticata","status":"publish","type":"post","link":"https:\/\/www.amyloidosisalliance.org\/it\/lamiloidosi-cardiaca-e-sottodiagnosticata\/","title":{"rendered":"L\u2019amiloidosi cardiaca \u00e8 sottodiagnosticata"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Lo abbiamo gi\u00e0 detto pi\u00f9 volte: l\u2019amiloidosi \u00e8 una malattia rara, poco conosciuta da tutti, anche dai medici. Questa scarsa conoscenza causa spesso ritardi nella diagnosi, in particolare nel caso dell\u2019amiloidosi cardiaca. In questo articolo spieghiamo che cos\u2019\u00e8 l\u2019amiloidosi cardiaca, presentiamo il caso di una paziente e spieghiamo come viene gestita la malattia.<\/p>\n\n<p class=\"wp-block-paragraph\">Il caso di cui parliamo \u00e8 stato presentato in questa pubblicazione: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30553561\/#affiliation-2\">Amyloid Cardiomyopathy in the Emergency Department<\/a><\/p>\n\n<h2 class=\"wp-block-heading\">Che cos\u2019\u00e8 l\u2019amiloidosi cardiaca?<\/h2>\n\n<p class=\"wp-block-paragraph\">Esistono diversi tipi di amiloidosi, ciascuno dovuto all\u2019accumulo di una proteina specifica. L\u2019amiloidosi cardiaca \u00e8 una malattia in cui proteine anomale si accumulano nel muscolo cardiaco, impedendo al cuore di funzionare correttamente. Con il tempo, e in assenza di un trattamento adeguato, ci\u00f2 pu\u00f2 portare a un\u2019insufficienza cardiaca: il cuore non riesce pi\u00f9 a pompare il sangue in modo efficace nell\u2019organismo.<\/p>\n\n<p class=\"wp-block-paragraph\">Per saperne di pi\u00f9 sull\u2019amiloidosi cardiaca: <a href=\"https:\/\/www.amyloidosisalliance.org\/it\/amiloidosi-cardiaca-e-trapianto\/#:~:text=Cardiac%20amyloidosis%20and%20transplantation%2025%2F04%2F2023%20Category%202%20End-stage,viable%20option%20for%20patients%20with%20end-stage%20cardiac%20amyloidosis.\">Amiloidosi cardiaca e trapianto<\/a><\/p>\n\n<h2 class=\"wp-block-heading\">Il caso di una paziente<\/h2>\n\n<p class=\"wp-block-paragraph\">Una donna di 83 anni si \u00e8 presentata in pronto soccorso per una dispnea crescente e un gonfiore degli arti inferiori. Riferiva una storia clinica di insufficienza cardiaca non specificata. Dopo alcuni esami in pronto soccorso, \u00e8 emerso quanto segue:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>segni di insufficienza cardiaca<\/li>\n\n\n\n<li>un elettrocardiogramma a basso voltaggio<\/li>\n\n\n\n<li>una radiografia del torace con lieve edema polmonare<\/li>\n\n\n\n<li>esami di laboratorio con peptide natriuretico di tipo B e troponina elevati<\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\">L\u2019ecografia cardiaca eseguita in pronto soccorso ha mostrato una grave ipertrofia ventricolare concentrica e un ispessimento del setto interventricolare, con un aspetto iperecogeno \u00abscintillante\u00bb del miocardio, una frazione di eiezione del ventricolo sinistro lievemente ridotta e un piccolo versamento pericardico.<\/p>\n\n<p class=\"wp-block-paragraph\">\u00c8 stata infine l\u2019ecocardiografia completa eseguita in ospedale, seguita da una scintigrafia con pirofosfato in medicina nucleare, a rivelare la causa dei disturbi di questa paziente: un\u2019amiloidosi cardiaca.<\/p>\n\n<p class=\"wp-block-paragraph\">La paziente si era recata inizialmente in pronto soccorso senza sapere di che cosa soffrisse. La maggior parte dei pazienti con amiloidosi avr\u00e0 lo stesso riflesso.<\/p>\n\n<p class=\"wp-block-paragraph\">Tuttavia, i medici di pronto soccorso trattano di solito l\u2019insufficienza cardiaca sistolica acuta o cronica con diuretici e con una riduzione del precarico e del postcarico mediante nitrati. Dovrebbe essere fondamentale riconoscere una cardiomiopatia amiloide fin dall\u2019arrivo in pronto soccorso, perch\u00e9 il trattamento deve comprendere i diuretici dell\u2019ansa ma deve evitare:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>i betabloccanti<\/li>\n\n\n\n<li>gli inibitori dell\u2019enzima di conversione dell\u2019angiotensina.<\/li>\n\n\n\n<li>i calcioantagonisti<\/li>\n\n\n\n<li>la digossina<\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\">Per questo, per non rischiare di aggravare le condizioni dei pazienti con amiloidosi cardiaca, facciamo tutto il possibile per formare le \u00e9quipe di pronto soccorso a riconoscere la malattia e ad avviare i primi trattamenti.<\/p>\n\n<h2 class=\"wp-block-heading\">Come viene gestita la malattia?<\/h2>\n\n<p class=\"wp-block-paragraph\">Come gi\u00e0 sappiamo, non esiste una cura per l\u2019amiloidosi. Diversi trattamenti possono per\u00f2 aiutare ad alleviare i sintomi e a rallentare la progressione della malattia, tra cui:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>farmaci che aiutano ad alleviare i sintomi e a migliorare la funzione cardiaca<\/li>\n\n\n\n<li>la chemioterapia, che pu\u00f2 essere usata per ridurre la produzione di proteine anomale<\/li>\n\n\n\n<li>il trapianto di cellule staminali, utilizzato solo in alcuni casi per sostituire le cellule responsabili con cellule sane che producono proteine normali<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>L\u2019amiloidosi cardiaca passa spesso inosservata, anche ai medici. Che cos\u2019\u00e8, un caso osservato in pronto soccorso e perch\u00e9 una diagnosi pi\u00f9 precoce \u00e8 importante.<\/p>\n","protected":false},"author":1,"featured_media":4500,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[68],"tags":[],"class_list":["post-4499","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-it"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>L\u2019amiloidosi cardiaca \u00e8 sottodiagnosticata<\/title>\n<meta name=\"description\" content=\"L\u2019amiloidosi cardiaca passa spesso inosservata, anche ai medici. 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