USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

How does Concentric Left Ventricular Hypertrophy typically develop?

1. Chronic hypovolemia

2. Volume overload

3. Pressure underload

4. Excessive physical activity

The correct answer is: Volume overload

Concentric left ventricular hypertrophy typically develops in response to sustained pressure overload. This condition is most commonly seen in situations where the heart is required to generate higher pressures to eject blood, such as in hypertension or aortic stenosis. Under these circumstances, the left ventricle adapts by thickening its walls to better cope with the increased workload, leading to the characteristic concentric pattern of hypertrophy. Volume overload, while it leads to a different pattern of hypertrophy (eccentric hypertrophy), is not the process associated with concentric left ventricular hypertrophy. In this situation, the heart chambers dilate to accommodate the increased volume of blood but does not lead to wall thickening in the same manner. Chronic hypovolemia would not typically cause concentric hypertrophy, as it results in decreased venous return and reduced cardiac workload. Similarly, pressure underload does not prompt the adaptive response seen in concentric hypertrophy since there is no significant pressure that the heart must work against. Excessive physical activity can lead to physiological hypertrophy, but it is generally associated with eccentric rather than concentric changes in the heart's structure.