CPD Questions (Apical Sparing Amyloid Cases)

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1. Which echocardiographic finding is considered the key feature of cardiac amyloidosis on global longitudinal strain (GLS)?:

A. Uniformly reduced strain in all LV segmentsB. Preserved basal strain with reduced apical strainC. Reduced basal and midventricular strain with preserved apical strainD. Hyperdynamic apical and basal strain

2. Which additional echocardiographic red flag finding is commonly associated with cardiac amyloidosis?:

A. Large LV cavity with eccentric hypertrophyB. Small pericardial effusion and biatrial enlargementC. Severe RV dilatation with concentric RV hypertrophyD. Small pericardial effusion with concentric LV hypertrophy

3. In Case 1, which combination of findings increased suspicion for wild-type ATTR cardiac amyloidosis?:

A. A history of carpal tunnel syndromeB. Low ECG voltagesC. Increased LV wall thicknessD. All the above

4. In Case 2, which haemodynamic pattern was consistent with paradoxical low-flow, low-gradient severe aortic stenosis (AS)?:

A. Low transvalvular gradients with preserved stroke volumeB. Reduced AVA with low flow despite preserved LVEFC. Reduced AVA with severe LV systolic dysfunctionD. Discordance between the AVA and DVI

5. In Case 3, what change occurred following treatment of AL amyloidosis?:

A. Improvement in GLS to a near-normal value with regression of cardiac featuresB. Worsening apical sparing pattern and declining GLSC. Development of severe LV systolic dysfunctionD. Progressive increase in LV wall thickness

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