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Cardiac amyloidosis — USMLE Step 3 MCQ

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HardInternal Medicine (Chronic Management)Cardiac amyloidosisUSMLE Step 3

A 69-year-old man has progressive dyspnea, preserved LVEF, severe concentric ventricular thickening, low-voltage ECG, nephrotic-range proteinuria, and bilateral carpal tunnel syndrome. He has no long-standing hypertension. Which of the following is the most likely diagnosis?

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Correct answer: D — Cardiac amyloidosis

Low-voltage ECG with ventricular thickening plus nephrotic proteinuria and carpal tunnel syndrome suggests amyloidosis.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials