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

Which of the following is a potential consequence of Eccentric LVH?

1. Decreased cardiac output

2. Left atrial pressure elevation

3. Normal stroke volume

4. Reduced left ventricular filling pressure

The correct answer is: Decreased cardiac output

Eccentric left ventricular hypertrophy (LVH) typically develops in response to volume overload conditions, such as in cases of valvular heart disease (like aortic regurgitation) or chronic anemia. As the left ventricle (LV) accommodates increased blood volume over time, its walls may thicken, but the chamber itself dilates. A potential consequence of this process is decreased cardiac output. Although the heart may initially adapt to the increased volume, over time, the heart's ability to contract effectively can decline due to wall stress, and ultimately it can lead to systolic dysfunction. The chamber dilation in eccentric hypertrophy can compromise the heart's pumping efficiency during contraction, especially under condition of stress or increased demand, leading to a reduction in cardiac output. In contrast, an increase in left atrial pressure is more commonly associated with concentric hypertrophy or conditions where there's diastolic dysfunction, which is not a primary feature of eccentric LVH. Normal stroke volume would not typically be expected in the context of ongoing volume overload and its associated cardiac remodeling. Lastly, reduced left ventricular filling pressure is not a consequence of eccentric LVH; instead, filling pressures are often elevated due to the increased volume that the left ventricle must