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

What pathological process is associated with Eccentric LVH due to aortic regurgitation?

1. Myocardial infarction

2. Myocarditis

3. Pulmonary hypertension

4. Volume overload

The correct answer is: Volume overload

Eccentric left ventricular hypertrophy (LVH) is primarily associated with volume overload conditions, such as aortic regurgitation. In aortic regurgitation, the aortic valve fails to close properly, allowing blood to flow back into the left ventricle during diastole. This results in an increase in the volume of blood the heart must handle in each cycle. As the left ventricle copes with this volume overload, it undergoes adaptations to maintain effective pump function. Instead of the concentric hypertrophy seen with pressure overload (where the heart wall thickens) in conditions like hypertension, the ventricle expands and the walls become thinner relative to the chamber size, leading to eccentric hypertrophy. This adaptation allows the ventricle to accommodate the increased volume, but over time, it can lead to decreased contractility and heart failure. In contrast to other conditions listed, myocardial infarction typically results in structural remodeling and scarring that does not directly cause eccentric hypertrophy due to volume overload; myocarditis refers to inflammation of the myocardium rather than a direct consequence of volume overload; pulmonary hypertension primarily affects the right side of the heart and can lead to right ventricular hypertrophy rather than left ventricular eccentric hypertrophy. Therefore