Adult Echocardiography Practice Exam

Which cardiomyopathy symptoms are only experienced during exercise?

1. Hypertrophic

2. Infiltrated

3. Congestive

4. Dilated

The correct answer is: Hypertrophic

Hypertrophic cardiomyopathy (HCM) is characterized by an abnormal thickening of the heart muscle, which can impede the heart's ability to pump blood effectively, particularly during periods of increased demand, such as exercise. During physical activity, the heart rate increases and the myocardial oxygen requirements elevate. In patients with HCM, this increased demand can lead to symptoms such as shortness of breath, chest pain, or even syncope (fainting). These symptoms are often absent at rest because the heart does not have to work as hard when the individual is not exerting themselves. Therefore, the clinical manifestations of HCM are notably exacerbated during exercise. In contrast, other types of cardiomyopathy like dilated or congestive cardiomyopathy typically present with symptoms at rest due to more generalized heart failure and impaired cardiac function. Infiltrated cardiomyopathy, which includes conditions where the heart muscle becomes stiffer (like in amyloidosis), may also cause symptoms that can be present at rest and are not limited to exertion. Thus, hypertrophic cardiomyopathy distinctly exhibits symptoms primarily during exercise due to the specific mechanical and physiological changes involved.