Adult Echocardiography Practice Exam

Heart failure with preserved ejection fraction (HFpEF) is characterized primarily by diastolic dysfunction, where the heart struggles to relax and fill properly during diastole. This impairment leads to elevated pressures in the ventricles and subsequently in the atria, causing increased filling pressures. These elevated pressures can often result in symptoms of heart failure.

In patients with HFpEF, echocardiographic findings typically include evidence of diastolic dysfunction as indicated by impaired mitral inflow patterns. Parameters such as the E/A ratio (the ratio of early diastolic mitral inflow velocity to late diastolic inflow velocity) are usually altered, reflecting the compromised ability of the left ventricle to fill adequately during diastole. Additionally, other findings may include left atrial enlargement and elevated pulmonary artery pressures due to the backward transmission of elevated filling pressures.

While normal left ventricular size with hypertrophy might be observed, it is not a definitive characteristic of HFpEF, as hypertrophy can occur in various conditions. Furthermore, HFpEF is not associated with increased stroke volume or high cardiac output, as this scenario typically applies to other forms of heart failure or different cardiac conditions. Severe aortic regurgitation is a separate