Wild-type transthyretin amyloidosis (ATTRwt) is increasingly recognized as an important cause of heart failure with preserved ejection fraction (HFpEF), affecting 13% in a consecutive series of cardiology and internal medicine patients admitted to a university hospital. 1 However, the diagnosis is often not considered due to the perceived rarity of the disease. Although the primary manifestation of ATTRwt is cardiac, approximately 50% of patients have a history of carpal tunnel syndrome, 2 with amyloid deposits in the flexor tenosynovium. 3 Spontaneous rupture of the distal biceps tendon (RBT) is uncommon, with an estimated prevalence of less than 1 per 1000 persons aged 56 to 74 years. 4 We observed RBT in several patients with ATTRwt cardiomyopathy, and performed a cross-sectional study to further evaluate.Methods | From December 2013 through January 2016, all patients with ATTRwt cardiomyopathy presenting to the Cardiac Amyloidosis Program at Brigham and Women's Hospital were systematically evaluated. The diagnosis of cardiac ATTRwt was based on histopathology of endomyocardial biopsy or positive result from technetium pyrophosphate scanning in the absence of a plasma cell dyscrasia. 5 Genetic testing was conducted to exclude mutant ATTR amyloidosis.Patients were asked about symptoms of RBT, date of onset, and associated trauma. RBT was defined as bunching of the biceps

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