A 53-year-old woman visits her physician with complaints of shortness of breath and fatigue over the last few weeks. Her past medical history includes hypertension diagnosed 20 years ago. She takes hydrochlorothiazide and losartan daily. Her mother died at the age of 54 from a stroke, and both of her grandparents suffered from cardiovascular disease. She has a 13 pack-year history of smoking and drinks alcohol occasionally. Her blood pressure is 150/120 mm Hg, pulse is 95/min, respiratory rate is 22/min, and temperature is 36.7°C (98.1°F). On physical examination, she has bibasilar rales, distended jugular veins, and pitting edema in both lower extremities. Her pulse is irregularly irregular and her apical pulse is displaced laterally. Fundoscopy reveals ‘copper wiring’ and ‘cotton wool spots’. Which of the following echocardiographic findings will most likely be found in this patient?
AEjection fraction: 55% with dilated chambers and thin walls
BEjection fraction: 60% with normal left ventricular wall thickness
CEjection fraction: 65% with rapid early diastolic filling and slow late diastolic filling
DEjection fraction: 40% with increased left ventricular wall thickness
EEjection fraction: 80% with regurgitant aortic valve
A 70-year-old man presented to a medical clinic for a routine follow-up. He has had hypertension for 20 years and is currently on multiple anti-hypertensive medications. The blood pressure is 150/100 mm Hg. The remainder of the examinations were within normal limits. Echocardiography showed some changes in the left ventricle. What is the most likely reason for the change?
ADisordered growth of the cardiac cells
BIncrease in number of normal cardiac cells
CReplacement of cardiac cells into stronger red fiber skeletal cells
DDecrease in cardiac cell size
EIncrease in cardiac cell size
An 80-year-old African American male presents complaining of worsening shortness of breath that occurs during his weekly round of golf. He also notes he has been waking up at night "choking and gasping for air", though he has been able to gain some relief by propping his head on a stack of pillows before he goes to bed. Upon auscultation, a low frequency, early diastolic gallop is heard over the apex while the patient rests in the left lateral decubitus position. This finding is most consistent with which of the following?
ALeft ventricular concentric hypertrophy
BRight atrial hypertrophy
CMitral stenosis
DLeft atrial hypertrophy
ELeft ventricular eccentric hypertrophy
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