Extracardiac Accumulation of Technetium-99m-Pyrophosphate in Transthyretin Cardiac Amyloidosis

Abstract This report presents a rare case of acute decompensated heart failure with technetium-99m-pyrophosphate accumulation in extracardiac sites, such as chest and abdominal walls, in addition to intense myocardial uptake of the tracer. Subsequently, an abdominal fat pad fine-needle aspiration biopsy, which provided positive findings for transthyretin amyloidosis, was performed. (Level of Difficulty: Advanced.)