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

What is the primary cause of Concentric Left Ventricular Hypertrophy?

1. Volume overload

2. Pressure overload

3. Age-related changes

4. Systemic inflammation

The correct answer is: Pressure overload

The primary cause of concentric left ventricular hypertrophy is indeed related to pressure overload. This form of hypertrophy typically occurs in response to sustained increases in pressure that the left ventricle must generate to pump blood effectively. Common causes include hypertension and aortic stenosis. When there is chronic pressure overload, the muscle fibers of the heart thicken to generate more forceful contractions against the elevated systemic blood pressure. This adaptation results in a relative increase in wall thickness without a significant increase in chamber size, which characterizes concentric hypertrophy. In contrast, volume overload leads to eccentric hypertrophy, in which the heart dilates and the wall thickness may increase in proportion to the chamber volume. The other options, such as age-related changes and systemic inflammation, can contribute to cardiovascular changes over time but are not primary causes of concentric hypertrophy in the way that sustained pressure overload effectively triggers this specific adaptive response in the heart.