A 43-year-old woman presents to her primary care provider with shortness of breath. She reports a 4-month history of progressively worsening difficulty breathing with associated occasional chest pain. She is a long-distance runner but has had trouble running recently due to her breathing difficulties. Her past medical history is notable for well-controlled hypertension for which she takes hydrochlorothiazide. She had a tibial osteosarcoma lesion with pulmonary metastases as a child and successfully underwent chemotherapy and surgical resection. She has a 10 pack-year smoking history but quit 15 years ago. She drinks a glass of wine 3 times per week. Her temperature is 98.6°F (37°C), blood pressure is 140/85 mmHg, pulse is 82/min, and respirations are 18/min. On exam, she has increased work of breathing with a normal S1 and loud P2. An echocardiogram in this patient would most likely reveal which of the following?
ABiventricular dilatation with a decreased ejection fraction
BLeft ventricular dilatation with an incompetent aortic valve
CLeft atrial dilatation with mitral valve stenosis
DRight ventricular hypertrophy with a dilated pulmonary artery
ELeft ventricular hypertrophy with a bicuspid aortic valve
A 45-year-old African American woman presents to her family physician for a routine examination. Past medical history is positive for amyloidosis and non-rhythm-based cardiac abnormalities secondary to the amyloidosis. Which of the following cardiac parameters would be expected in this patient?
AIncreased ejection fraction and decreased compliance
BPreserved ejection fraction and increased compliance
CPreserved ejection fraction and decreased compliance
DIncreased ejection fraction and increased compliance
EDecreased ejection fraction and normal compliance
A 27-year-old woman comes to the physician because of a 1-year history of progressive shortness of breath. She is now unable to jog for more than 10 minutes without stopping to catch her breath. Cardiac examination shows a harsh systolic, crescendo-decrescendo murmur best heard at the lower left sternal border. The murmur increases in intensity when she moves from a squatting to a standing position and decreases when she clenches her fists. The lungs are clear to auscultation. Which of the following is the most likely cause of her condition?
AMyosin heavy chain defect
BCTG trinucleotide repeats
CDystrophin defect
DGAA trinucleotide repeats
EFibrillin-1 defect
+ 7 more in the PDF
Browse all chapters