A 55-year-old man comes to the cardiology clinic because of a new ECG findings during last visit. An ECG shows left ventricular hypertrophy. The patient feels well and has had no shortness of breath, fatigue, or leg swelling. He has no other medical conditions, takes no medications, and does not use tobacco, alcohol, or illicit drugs. Blood pressure is 155/90 mm Hg and pulse is 80/min. BMI is 35 kg/m². Physical examination shows normal jugular venous pressure. There are no lung crackles, heart gallops, or lower extremity edema. Echocardiography reveals a left ventricular ejection fraction of 30%. Which of the following patterns of chemical mediators is most likely present in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Asymptomatic left ventricular systolic dysfunction is a common stage in the progression of heart failure.  Neurohormonal mechanisms, including the sympathetic nervous system and renin-angiotensin-aldosterone system, help maintain the asymptomatic period by increasing volume retention and peripheral resistance to maintain organ perfusion.  Although these mechanisms are beneficial in the short term, they are ultimately deleterious, increasing hemodynamic stress and cardiac remodeling that eventually lead to decompensated heart failure.

A 55-Year-Old Man Comes to the Cardiology Clinic Because of a New