Would testing for ATTR cardiac amyloidosis be considered in an older patient with bilateral carpal tunnel surgeries and multiple spinal stenosis surgeries, but no obvious cardiac symptoms?

I would not look for ATTR-CM in the absence of cardiac findings such as abnormal echo (increased LV thickness) or conduction abnormalities that are suggestive.

Only 10% of patients with bilateral CTS have ATTR-CM.

I would do an echo if not done and review ECG.

As much as we are concerned about under...