National Heart Centre Singapore Launches Dedicated Cardiac Amyloidosis Programme To Support Earlier Diagnosis And Coordinated Care

The multidisciplinary programme aims to help patients receive earlier diagnosis, coordinated treatment and long-term care as Singapore’s population ages.

Singapore, 16 September 2026 – When Mr Tan began experiencing breathlessness during walks, unusual fatigue and loss of appetite, the 60-year-old private-hire driver initially dismissed the symptoms.  Over time, his weight dropped from 80kg to 50kg. 

When his breathlessness persisted, he consulted his general practitioner and was referred to National Heart Centre Singapore (NHCS). Further investigations showed that he had transthyretin amyloid cardiomyopathy or ATTR-CM. This is a condition in which abnormal proteins known as amyloid, accumulate in the heart muscle, making it harder for the heart to pump blood effectively. 

Since starting treatment at NHCS, including targeted medication, Mr Tan’s condition has stabilised. Changes to his daily routine, such as eating smaller and more frequent meals, have helped him regain his appetite and weight. Cardiac rehabilitation and physiotherapy have also helped him rebuild his strength and mobility. 

Because its early symptoms such as breathlessness, fatigue and swelling in the legs can resemble those of more common heart conditions, cardiac amyloidosis may go unrecognised until the heart and other organs have already been affected.

To address these needs, NHCS has launched a dedicated Cardiac Amyloidosis Programme that brings together expertise in early recognition, diagnosis, treatment and long-term management of this complex condition. The multidisciplinary programme brings together NHCS specialists and healthcare professionals across Cardiomyopathy, Advanced cardiac imaging, Cardiogenetics, Pharmacy, Physiotherapy and Medical Social Services, working alongside specialists from Singapore General Hospital (SGH) Department of Haematology and neurologists from National Neuroscience Institute (NNI), within a coordinated care pathway. Patients are supported from initial evaluation and diagnosis through personalised treatment, rehabilitation and long-term care. 

A disease that can affect more than the heart

Cardiac amyloidosis is a condition in which abnormal proteins called “amyloid fibrils” build up in the heart. Over time, this causes the heart walls to become thick and stiff, making it harder for the heart to fill and pump normally. This can lead to heart failure. The two main types that affect the heart are transthyretin amyloidosis (ATTR) and light-chain (AL) amyloidosis. ATTR amyloidosis may be associated with ageing or may be hereditary, while AL amyloidosis is caused by bone marrow abnormalities and requires close collaboration between Haematology and Cardiology specialists. 

“Cardiac amyloidosis does not always present in an obvious way. A patient may see different healthcare professionals for seemingly unrelated problems before the underlying condition is recognised,” said Assistant Professor Khoo Chun Yuan, Deputy Director, Cardiomyopathy, Cardiovascular Ageing and Longevity Programme (CRANE) and Senior Consultant, Department of Cardiology, NHCS. “By bringing different specialties together, we can connect these clinical clues, carry out the appropriate investigations and coordinate care across the patient’s journey. Earlier recognition is increasingly important because treatments are now available that can improve outcomes.” 

From diagnosis to living well 

The NHCS Cardiac Amyloidosis Programme supports patients across different stages of care. 

Recognise early warning signs: The programme’s multidisciplinary team evaluates not only the symptoms involving the heart, but also the nerves and other organs. This enables the team to build a more complete clinical picture and identify patients who may require further investigations.   

Establishing an accurate diagnosis: Patients with suspected cardiac amyloidosis may undergo investigations including echocardiography, cardiac magnetic resonance imaging (MRI) and pyrophosphate (PYP) nuclear imaging. Where appropriate, biopsy and genetic testing may also be performed to confirm the diagnosis, determine the type of amyloidosis and guide treatment.

Personalised treatment: Following diagnosis, treatment is tailored to the type of amyloidosis and each patient’s needs. This may include disease-modifying therapies, management of heart failure symptoms, and where appropriate, participation in clinical trials evaluating emerging therapies. 

Supporting the whole person: Beyond medical treatment, the programme addresses the wider impact of living with a long-term, complex condition. Specialist nurses and pharmacists provide education and treatment support, while frailty assessment, cardiac rehabilitation and physiotherapy help patients maintain physical function and independence. Medical social workers provide financial, practical and psychosocial support where needed. 

Providing long-term follow-up: Patients remain under regular follow-up, allowing the team to monitor their condition, assess treatment response and adapt care as their needs change. 

Meeting the cardiovascular needs of an ageing population 

Singapore's population is ageing rapidly, with one in four residents projected to be 65 and above by 2030. Age-related ATTR amyloidosis is increasingly recognised as a cause of heart failure in older adults. 

“Symptoms such as breathlessness and fatigue can easily be attributed to ageing, but they should not simply be accepted as an inevitable part of growing older,” said Associate Professor Angela Koh, Director of Cardiovascular Ageing and Longevity Programme (CRANE) and Senior Consultant, Department of Cardiology, NHCS. “As more Singaporeans live longer, we need to become better at recognising specific heart conditions that become more common with age. Timely evaluation can help patients receive appropriate treatment earlier and preserve their independence and quality of life for longer.” 

Professor Yeo Khung Keong, Chief Executive Officer, NHCS, said: "This programme brings together the clinical expertise, diagnostic capabilities and long-term support needed to manage a condition that crosses several medical disciplines. It reflects NHCS’s commitment not only to treating disease, but also helping patients maintain their function, independence and quality of life.”