Cardiology 1-50

A 45-year-old man with a history of exertional dyspnea and near-syncopal episodes presents for evaluation. His father died suddenly at age 50 due to an unknown cardiac condition. On examination, he has a harsh systolic murmur that increases with the Valsalva maneuver. Echocardiography confirms hypertrophic obstructive cardiomyopathy (HOCM) with asymmetric septal hypertrophy and a resting left ventricular outflow tract (LVOT) gradient of 40 mmHg.

 

Which of the following are significant risk factors for developing hypertrophic obstructive cardiomyopathy? Select five (5) Correct answer.

 

A 38-year-old woman presents with palpitations, exertional chest pain, and dizziness. Her younger brother, a professional soccer player, was diagnosed with hypertrophic obstructive cardiomyopathy (HOCM) last year. On auscultation, she has a crescendo-decrescendo systolic murmur that worsens with standing. Echocardiography confirms left ventricular hypertrophy with a systolic anterior motion of the mitral valve.

 

Which of the following are established risk factors for hypertrophic obstructive cardiomyopathy? Select five (5) Correct answer.

 

A 28-year-old male presents to the clinic complaining of exertional fatigue and dizziness. He has noticed that his symptoms worsen when standing up quickly or after prolonged physical activity. He has no history of hypertension or diabetes. His father passed away suddenly at age 42 from an unknown cardiac condition. You suspect hypertrophic obstructive cardiomyopathy. On physical examination, his blood pressure is 118/70 mmHg, and his heart rate is 74 bpm. What other signs you will look for to aid with your diagnosis.

 

Which of the following physical examination findings are commonly associated with this condition? Select five (5) Correct answer.

 

A 40-year-old woman presents with progressive exertional dyspnea and intermittent palpitations. She reports that she has experienced occasional dizziness and near-fainting spells, particularly when standing for long periods. She denies chest pain but notes that she often feels her heart pounding against her chest when lying on her left side. Her father died suddenly at 48 years of age.

On examination, her pulse is 82 bpm and regular, and her blood pressure is 115/68 mmHg. You suspect hypertrophic obstructive cardiomyopathy. What other signs you will look for to aid with your diagnosis.

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Which of the following physical examination findings are most commonly associated with this condition? Select five (5) Correct answer.

 

A 30-year-old man presents with exertional dyspnea, palpitations, and occasional dizziness. He reports that his father passed away suddenly at the age of 42 from a cardiac condition. The patient denies any history of hypertension or coronary artery disease.

On examination, his blood pressure is 118/70 mmHg, and a harsh systolic murmur is heard at the left lower sternal border, which increases in intensity with the Valsalva maneuver and decreases with squatting. His ECG shows deep Q waves in leads V2–V4 and left ventricular hypertrophy.

 

Which of the following investigations are most appropriate for confirming the diagnosis and assessing disease severity? Select five (5) Correct answer.

 

A 42-year-old woman presents with intermittent palpitations, exertional dyspnea, and lightheadedness. She reports that she occasionally feels a “fluttering” sensation in her chest and had one episode of near-fainting while climbing stairs. Her father died suddenly at the age of 50. On examination, she has a systolic murmur that increases with Valsalva and decreases with squatting. Her ECG reveals left ventricular hypertrophy with deep T-wave inversions in leads V2–V4.

 

Which of the following investigations are essential for diagnosing and managing this condition? Select five (5) Correct answer.

 

A 29-year-old male presents with exertional dyspnea, palpitations, and occasional dizziness. He reports a strong family history of sudden cardiac death, with his uncle and grandfather both passing away unexpectedly before the age of 50. He denies any history of hypertension, diabetes, or coronary artery disease.

On examination, his blood pressure is 118/72 mmHg, and a harsh systolic murmur is heard at the left lower sternal border, which increases with the Valsalva maneuver and decreases with squatting. ECG shows left ventricular hypertrophy with deep Q waves in leads V2–V4. Echocardiography reveals asymmetric septal hypertrophy with a left ventricular outflow tract (LVOT) gradient of 50 mmHg at rest.

 

Which of the following are appropriate management strategies for this condition? Select five (5) Correct answer.

 

A 37-year-old woman presents with progressive shortness of breath and chest discomfort. She reports occasional dizziness and one episode of syncope after standing for a long period. Her father passed away suddenly in his 40s, and her younger brother was recently diagnosed with a heart condition. On examination, her blood pressure is 110/65 mmHg, and she has a harsh systolic murmur that increases with standing and Valsalva. ECG shows left ventricular hypertrophy with repolarization abnormalities. Echocardiography reveals asymmetric septal hypertrophy with systolic anterior motion of the mitral valve and a resting LVOT gradient of 45 mmHg.

 

Which of the following treatment approaches are appropriate for this condition? Select five (5) Correct answer.

 

A 33-year-old male presents with increasing episodes of exertional dyspnea and dizziness. He describes experiencing palpitations and has had two near-syncope episodes in the past month, both occurring during exercise. He has no prior history of hypertension, diabetes, or coronary artery disease. His father passed away suddenly at the age of 40.

On examination, his blood pressure is 115/70 mmHg, and a harsh systolic murmur is heard at the left lower sternal border, which increases with Valsalva and decreases with squatting. ECG reveals left ventricular hypertrophy and deep T-wave inversions in leads V2–V4. Echocardiography shows asymmetric septal hypertrophy with a left ventricular outflow tract (LVOT) gradient of 55 mmHg.

 

Which of the following are potential complications of this condition? Select five (5) Correct answer.

 

A 41-year-old woman presents with worsening shortness of breath and intermittent palpitations. She reports two episodes of syncope in the past year and frequent dizziness with exertion. Her father died suddenly at 45, and her younger brother has been diagnosed with a cardiac condition.

On examination, she has a harsh systolic murmur that increases with standing and decreases with squatting. ECG shows left ventricular hypertrophy with T-wave inversions. Echocardiography reveals asymmetric septal hypertrophy with a resting LVOT gradient of 60 mmHg and mild mitral regurgitation.

 

Which of the following are recognized complications of this condition? Select five (5) Correct answer.

 

A 36-year-old male presents for evaluation after experiencing two episodes of syncope while playing soccer. He reports occasional palpitations and exertional chest discomfort. He has no history of hypertension, diabetes, or coronary artery disease.

On examination, his blood pressure is 118/72 mmHg, and he has a harsh systolic murmur at the left lower sternal border, which increases with Valsalva maneuver and decreases with squatting. ECG shows left ventricular hypertrophy with deep Q waves in leads V2–V4. Echocardiography reveals asymmetric septal hypertrophy with a resting left ventricular outflow tract (LVOT) gradient of 50 mmHg.

 

Which of the following factors are associated with a worse prognosis in this condition? Select five (5) Correct answer.

 

A 42-year-old woman presents with occasional dizziness and palpitations. She has had one episode of syncope while climbing stairs. Her father died suddenly in his 40s. She has no significant past medical history but avoids strenuous exercise due to worsening fatigue.

On examination, her blood pressure is 110/65 mmHg, and a harsh systolic murmur is heard at the left lower sternal border, which increases with standing. ECG shows left ventricular hypertrophy with repolarization abnormalities. Echocardiography reveals asymmetric septal hypertrophy with an LVOT gradient of 45 mmHg.

 

Which of the following factors are associated with a better prognosis in this condition? Select five (5) Correct answer.

A 28-year-old woman presents with persistent palpitations and lightheadedness over the past few weeks. She reports increased stress at work and recent poor sleep. She denies chest pain, syncope, or significant medical history. She consumes 3–4 cups of coffee daily and occasionally takes over-the-counter cold medications.

On examination, her blood pressure is 118/75 mmHg. ECG is given below with normal P waves and QRS complexes. No evidence of ischemia or conduction abnormalities is noted.

 

Which of the following important factors are known to contribute to this condition? Select five (5) Correct answer.

 

 

 

A 45-year-old man presents with a complaint of rapid heartbeats over the past few weeks. He denies chest pain, but reports frequent fatigue and mild shortness of breath. He has a history of hypertension and takes lisinopril. He recently recovered from a respiratory infection. He drinks 3–4 alcoholic beverages weekly and smokes half a pack of cigarettes daily.

On examination, his blood pressure is 130/80 mmHg. Laboratory tests show normal hemoglobin and renal function, with a borderline low potassium level. ECG is given below

 

Which of the following are important recognized contributors to this condition? Select five (5) Correct answer.

 

 

A 26-year-old woman presents to the clinic with complaints of a persistently fast heart rate, occasional dizziness, and shortness of breath over the past two weeks. She denies chest pain, syncope, or significant medical history. She recently recovered from a viral illness and reports increased fatigue.

On examination, her pulse is 115 bpm, blood pressure is 110/70 mmHg, and her respiratory rate is 18 breaths per minute. ECG is given below

 

Which of the following investigations are most appropriate to identify the underlying cause of this condition? Select five (5) Correct answer.

 

 

A 42-year-old man presents with episodes of a rapid heartbeat, mild chest discomfort, and occasional dizziness over the past three weeks. He has no significant medical history but reports frequent stress at work. He denies fainting, excessive caffeine intake, or use of illicit drugs. On examination, his blood pressure is 125/78 mmHg, No murmurs are heard on auscultation.

 

Which of the following investigations would be most useful in assessing the underlying cause of this condition? Select five (5) Correct answer.

 

 

 

A 30-year-old woman presents to the clinic with complaints of a persistently fast heartbeat, dizziness, and occasional shortness of breath. She reports that her symptoms worsen with stress and caffeine intake. She denies any history of cardiovascular disease or thyroid disorders. On examination, her blood pressure is 115/75 mmHg,

 

Which of the following are appropriate management strategies for this condition? Select five (5) Correct answer.

 

 

 

A 41-year-old man presents with complaints of frequent palpitations and intermittent dizziness over the past month. He reports that his symptoms worsen with stress and after consuming alcohol. He denies any history of heart disease but mentions a recent diagnosis of hyperthyroidism. On examination, his blood pressure is 125/80 mmHg,

 

Which of the following are appropriate management strategies for this condition? Select five (5) Correct answer.

 

 

A 35-year-old woman presents with persistent palpitations and episodes of lightheadedness over the past two months. She denies syncope or significant medical history but reports frequent stress due to work. She consumes three cups of coffee daily and exercises regularly.

 

Which of the following factors are associated with a worse prognosis in this condition? Select five (5) Correct answer.

 

 

A 42-year-old man presents with complaints of frequent palpitations and mild breathlessness over the past few months. He denies any history of chest pain, syncope, or prior heart disease. His blood pressure is 120/78 mmHg.

 

Which of the following factors are associated with a better prognosis in this condition? Select five (5) Correct answer.

 

 

A 45-year-old man presents to the emergency department with pleuritic chest pain that worsens when lying flat and improves when sitting up. He had a recent upper respiratory infection two weeks ago but otherwise has no significant medical history. He denies fever, recent travel, or trauma.

 

On examination, his temperature is 37.8°C, and blood pressure is 122/78 mmHg. ECG is given below

 

Which of the following factors are known to increase the risk of this condition? Select five (5) Correct answer.

 

 

 

A 52-year-old woman presents with sharp, pleuritic chest pain that has worsened over the past three days. She had a myocardial infarction three weeks ago and was discharged home on aspirin, beta-blockers, and a statin. She has a history of systemic lupus erythematosus and chronic kidney disease. On examination, her temperature is 38.2°C, heart rate is 102 bpm, and she appears mildly short of breath. ECG is given below

 

Which of the following factors are associated with an increased risk of developing this condition? Select five (5) Correct answer.

 

 

 

A 48-year-old man presents with sharp chest pain that has worsened over the past three days. He describes the pain as pleuritic, worsening when lying down and improving when sitting forward. He denies recent trauma but reports having had an upper respiratory infection a week ago. On examination, his temperature is 38°C, \ and blood pressure is 120/76 mmHg.. ECG is given below

 

Which of the following signs are indicative of a more severe or complicated form of this condition? Select five (5) Correct answer.

 

 

 

A 55-year-old woman presents with progressively worsening chest discomfort and fatigue over the past week. She reports mild shortness of breath and a sensation of fullness in her chest. She denies fever or recent infections but has a history of radiation therapy for breast cancer five years ago. On examination, her blood pressure is 98/65 mmHg, and she has distended neck veins. Heart sounds are distant. ECG is given below

 

Which of the following signs suggest a more severe or complicated progression of this condition? Select five (5) Correct answer.

 

 

A 37-year-old man presents with pleuritic chest pain that has persisted for the past five days. The pain worsens when he lies flat and improves when sitting up. He reports mild fever and recent flu-like symptoms. He has no history of hypertension, coronary artery disease, or recent trauma. On examination, his blood pressure is 118/75 mmHg, pulse is 98 bpm, and he appears mildly uncomfortable. A pericardial friction rub is audible over the left lower sternal border. ECG is given below

 

Which of the following investigations are most appropriate to confirm the diagnosis and assess for complications? Select five (5) Correct answer.

 

 

A 50-year-old woman presents with worsening chest pain over the past week. She describes the pain as sharp and pleuritic, worsening when lying down. She has a history of systemic lupus erythematosus (SLE) and was recently treated for a respiratory infection. On examination, she appears mildly dyspneic. Her heart sounds are distant, and her jugular veins are distended. ECG is given below

 

Which of the following investigations are necessary to confirm the diagnosis and evaluate severity? Select five (5) Correct answer.

 

 

 

 

A 42-year-old man presents to the emergency department with sharp chest pain that worsens when lying down and improves when sitting forward. He reports a recent upper respiratory infection but denies exertional chest pain or dyspnea on exertion. His vital signs are stable, and a pericardial friction rub is heard on auscultation. ECG is given below

 

Which of the following management strategies are appropriate for this condition? Select five (5) Correct answer.

 

 

 

A 50-year-old woman presents with progressively worsening chest discomfort and fatigue over the past week. She has a history of systemic lupus erythematosus (SLE) and was recently treated for pneumonia. Examination reveals distant heart sounds and jugular venous distension. Echocardiography confirms a moderate pericardial effusion without signs of tamponade.

 

Which of the following management strategies are appropriate for this condition? Select five (5) Correct answer.

 

A 39-year-old man presents with sharp chest pain that worsens when lying flat and improves when sitting forward. He was recently diagnosed with an upper respiratory infection. His ECG is given below. Echocardiography reveals a small pericardial effusion.

 

Which of the following factors are associated with a worse prognosis in this condition? Select five (5) Correct answer.

 

 

 

A 54-year-old woman presents with pleuritic chest pain and mild fatigue. She has a history of systemic lupus erythematosus (SLE). Examination reveals a pericardial friction rub. Echocardiography shows a moderate pericardial effusion without signs of tamponade.

 

Which of the following factors are associated with a better prognosis in this condition? Select five (5) Correct answer.

 

A 58-year-old man presents with increasing fatigue and mild shortness of breath over the past several months. He reports occasional palpitations and a sensation of pounding in his chest when lying down. He has a history of hypertension On examination, his blood pressure is 145/55 mmHg, and a diastolic murmur is heard along the left sternal border. His pulse is described as “bounding.”

 

Which of the following factors are associated with an increased risk of developing this condition? Select five (5) Correct answer.

 

A 62-year-old woman presents with exertional breathlessness and occasional chest discomfort. She has a history of long-standing hypertension and was recently diagnosed with a connective tissue disorder. She denies any recent infections or trauma.

On examination, her blood pressure is 160/60 mmHg, and a diastolic murmur is heard at the right second intercostal space. Peripheral pulses are described as “bounding.”

 

Which of the following factors increase the risk of developing this condition? Select five (5) Correct answer.

 

A 62-year-old man presents with complaints of progressive exertional fatigue and a sensation of a strong heartbeat, particularly when lying down. He has a history of hypertension but no prior cardiac events. His blood pressure is 140/50 mmHg. On examination, a diastolic murmur is heard at the left sternal border, and his peripheral pulses appear prominent.

 

Which of the following physical examination findings are associated with this condition? Select five (5) Correct answer.

 

A 58-year-old woman presents with palpitations and mild breathlessness on exertion. She reports occasional dizziness and a throbbing sensation in her head. Her blood pressure is 145/50 mmHg. Examination reveals a diastolic murmur at the right second intercostal space and unusually strong peripheral pulses.

 

Which of the following physical examination findings are associated with this condition? Select five (5) Correct answer.

A 60-year-old man presents with progressive exertional breathlessness and palpitations. He has a history of hypertension and a previous episode of infective endocarditis. His blood pressure is 145/50 mmHg. Examination reveals a diastolic murmur along the left sternal border and bounding peripheral pulses.

 

Which of the following investigations are most appropriate to confirm the diagnosis and assess severity? Select five (5) Correct answer.

 

A 55-year-old woman presents with worsening fatigue and palpitations over the last six months. She reports occasional dizziness and exertional dyspnea. Her blood pressure is 150/50 mmHg, and examination reveals a diastolic murmur at the right upper sternal border with a collapsing pulse.

 

Which of the following investigations are essential for confirming the diagnosis and guiding management? Select five (5) Correct answer.

 

A 64-year-old man presents with progressive exertional dyspnea, palpitations, and occasional chest discomfort over the past year. His blood pressure is 140/50 mmHg. On examination, a high-pitched diastolic murmur is heard along the left sternal border, and his peripheral pulses are bounding. Echocardiography confirms a severe valvular abnormality with left ventricular enlargement.

 

Which of the following management strategies are most appropriate for this condition? Select five (5) Correct answer.

A 57-year-old woman presents with worsening exertional dyspnea and a pounding heartbeat sensation. She has a history of hypertension and connective tissue disorder. Examination reveals a wide pulse pressure and a diastolic murmur at the right upper sternal border. Echocardiography shows a regurgitant fraction of 55% with left ventricular dilation.

 

Which of the following management approaches are appropriate for this condition? Select five (5) Correct answer.

 

A 58-year-old man presents with exertional dyspnea and palpitations. He has a history of hypertension and was recently diagnosed with a valvular abnormality. His echocardiogram shows moderate left ventricular dilation but preserved ejection fraction. He remains active and denies symptoms at rest.

 

Which of the following factors are associated with a worse prognosis in this condition? Select five (5) Correct answer.

 

A 62-year-old woman presents with worsening fatigue and exertional dyspnea over the past six months. She has a history of hypertension and previous aortic valve disease. Echocardiography shows a left ventricular ejection fraction of 45% and moderate valve dysfunction.

 

Which of the following factors are associated with a better prognosis in this condition? Select five (5) Correct answer.

 

A 65-year-old man presents with progressive exertional dyspnea and occasional dizziness over the past year. He has a history of hypertension and hyperlipedeamia. He denies chest pain but reports fatigue with physical activity. His blood pressure is 135/80 mmHg. On examination, a systolic ejection murmur is heard at the right second intercostal space, radiating to the carotids.

Which of the following factors increase the risk of developing this condition? Select five (5) Correct answer.

A 72-year-old woman presents with worsening shortness of breath, particularly when climbing stairs. She has a history of chronic kidney disease. She denies chest pain but notes occasional lightheadedness. Her blood pressure is 140/70 mmHg. On examination, a harsh systolic murmur is heard at the right upper sternal border, radiating to the neck.

 

Which of the following factors increase the risk of developing this condition? Select five (5) Correct answer.