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No guidelines exist on the use of guideline-directed medical therapy (GDMT) in the treatment of patients with transthyretin cardiac amyloidosis (TTR-CA) and heart failure with reduced ejection fraction (HFrEF), and its use remains controversial. There are no survival data demonstrating the effects of beta-blockers in patients with TTR-CA, and the efficacy of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and angiotensin receptor-neprilysin inhibitors (ARNIs) is uncer

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ardiac amyloidosis “is an infiltrative cardiomyopathy that usually presents with angina, syncope, and progressive right- and left-sided heart failure. It leads to significant morbidity and mortality which is compounded by the fact that it is a diagnostic challenge even with imaging.”