Question 1

Which of the following best distinguishes systolic heart failure from diastolic heart failure in terms of ejection fraction (EF)?

Accepted Answer

Systolic heart failure has an EF \u003c 50%, while diastolic heart failure has an EF ≥ 50%.

Question 2

A patient presents with shortness of breath, exercise intolerance, and edema. Echocardiography reveals a preserved ejection fraction and no ventricular dilation. Which type of heart failure is most likely?

Accepted Answer

Diastolic heart failure

Question 3

Given the formula $$EF = \frac{EDV - ESV}{EDV}$$, calculate the ejection fraction if the end-diastolic volume (EDV) is 120 mL and the end-systolic volume (ESV) is 60 mL.

Accepted Answer

$$EF = \frac{120 - 60}{120} = 0.5 or 50$$%

Question 4

Which of the following is a hallmark of diastolic dysfunction in heart failure with preserved ejection fraction (HFpEF)?

Accepted Answer

Impaired ventricular relaxation

Question 5

In the context of diastolic dysfunction, what is the primary effect of decreased cytosolic calcium during diastole?

Accepted Answer

It allows for ventricular relaxation and filling.

Question 6

A Doppler echocardiogram shows an E/A ratio 150 ms). What does this pattern most likely indicate?

Accepted Answer

Early diastolic dysfunction (impaired relaxation)

Question 7

Which of the following is a common etiology of hypertrophic cardiomyopathy (HCM)?

Accepted Answer

Genetic mutations in sarcomeric proteins such as β-myosin heavy chain

Question 8

A patient with hypertrophic cardiomyopathy (HCM) is started on a beta-blocker. What is the primary therapeutic goal of this medication?

Accepted Answer

Decrease heart rate to increase diastolic filling time

Question 9

Which of the following best describes the structural difference between hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM)?

Accepted Answer

HCM is characterized by increased ventricular wall thickness, while RCM has normal or increased wall thickness with stiff ventricular walls.

Question 10

A patient with restrictive cardiomyopathy (RCM) is found to have amyloidosis. What is the most important aspect of treatment for this patient?

Accepted Answer

Treat the underlying cause (amyloidosis)

Question 11

Which of the following best explains why patients with advanced HFpEF may develop a restrictive filling pattern on echocardiography?

Accepted Answer

Elevated left atrial pressure leading to rapid early filling (high E wave) and blunted A wave

Question 12

Which of the following is a key pathophysiological mechanism in the development of diastolic dysfunction in HFpEF?

Accepted Answer

Impaired calcium reuptake into the sarcoplasmic reticulum

Question 13

A 65-year-old patient with a history of hypertension and diabetes presents with symptoms of heart failure. Echocardiography shows preserved ejection fraction and increased left ventricular wall thickness. Which diagnosis is most likely?

Accepted Answer

Hypertrophic cardiomyopathy

Question 14

Which of the following best describes the compensation seen in early diastolic dysfunction (HFpEF) as observed on Doppler echocardiography?

Accepted Answer

Decreased E wave and increased A wave

Question 15

Which of the following is a distinguishing feature of restrictive cardiomyopathy (RCM) compared to hypertrophic cardiomyopathy (HCM)?

Accepted Answer

RCM is characterized by stiff ventricular walls with normal or increased wall thickness, while HCM is characterized by asymmetric septal hypertrophy.

Question 16

Which of the following therapies is specifically indicated for symptomatic obstructive hypertrophic cardiomyopathy (HCM) and acts as a cardiac myosin inhibitor?

Accepted Answer

Mavacamten

Question 17

A patient with restrictive cardiomyopathy (RCM) is being considered for advanced therapy. Which of the following is an appropriate advanced treatment option?

Accepted Answer

Heart transplant

Question 18

Which of the following best describes the E/A ratio in a patient with normal diastolic function?

Accepted Answer

E/A \u003e 1

Question 19

Which of the following is a common clinical symptom shared by both systolic and diastolic heart failure?

Accepted Answer

Shortness of breath

Question 20

A patient with heart failure has the following echocardiographic findings: normal ventricular dimensions, stiff ventricular walls, and dilated atria. Which diagnosis is most likely?

Accepted Answer

Restrictive cardiomyopathy

Heart Failure: Systolic and Diastolic Dysfunction, HFpEF, HCM, and RCM

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