68-year-old man with HFrEF presents with progressive dyspnea and orthopnea.
Echo:
LVEF 30%
Dilated LV
Moderate functional MR
Enlarged LA
E/e′ = 18
PASP = 55 mmHg
Despite loop diuretic therapy, dyspnea persists.
❓What is the MOST likely mechanism responsible for his elevated pulmonary artery pressure?
🅰️ Primary pulmonary arterial disease
🅱️ Increased left atrial pressure due to elevated LV filling pressure
🅲️ Increased right ventricular contractility
🅳️ Left-to-right shunt causing increased pulmonary blood flow
👇 What’s your answer?
Comment A, B, C, or D — and explain WHY.
🧠 Don't memorize. Think pathophysiology.
LV → LA → Pulmonary veins → Pulmonary artery
#Cardiology #Braunwald #CardiologyQuiz #HFrEF #HeartFailure #Echocardiography #Hemodynamics #PulmonaryHypertension #Cardiologist #ECG #Echo #MedicalEducation #CardiologyChallenge
September 2, 2026 154
