Adult Echocardiography Practice Exam

Which condition causes a decrease in left atrial filling?

1. Systolic dysfunction

2. Diastolic dysfunction

3. Coarctation

4. Constrictive pericarditis

The correct answer is: Constrictive pericarditis

Constrictive pericarditis is characterized by abnormal thickening and fibrosis of the pericardium, which restricts the movement of the heart. This restriction impairs the heart's ability to fill properly during diastole, leading to reduced left atrial filling. As the left atrium receives blood from the pulmonary veins, any limitation in the heart's ability to expand results in decreased filling of the left atrium due to the inability of the ventricles to accommodate the normal volume of blood returning from the lungs. In contrast, systolic dysfunction primarily involves the inability of the heart to contract efficiently, potentially leading to lower blood flow and pressure that could affect filling, but it does not directly cause a decrease in left atrial filling in the same way as the structural limitations seen in constrictive pericarditis. Diastolic dysfunction focuses on the impaired relaxation of the ventricles and, while it can affect left atrial pressures and filling, it does not create the same structural restriction as constrictive pericarditis. Coarctation, which is a narrowing of the aorta, also does not directly affect the dynamics of left atrial filling in the same confined way, instead primarily impacting systemic blood flow. Thus, while