Cardiology: restrictive cardiomyopathy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: restrictive cardiomyopathy

Sample item

A patient with heart failure has normal ventricular wall thickness on echo, biatrial enlargement and a dip-and-plateau pressure tracing on catheterisation. Which cause is most likely among the options?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hemochromatosis or amyloidosis causing restrictive cardiomyopathy

The square-root sign reflects rapid early filling that halts abruptly because of a stiff ventricle. Amyloidosis, haemochromatosis, sarcoidosis and endomyocardial fibrosis are classic causes. In amyloid, wall thickness is usually increased with low voltage on ECG.

Option by option

  • A. Aortic stenosis

    Aortic stenosis causes pressure overload with a gradient across the valve.

  • B. Hemochromatosis or amyloidosis causing restrictive cardiomyopathy (correct)

    Correct. Infiltrative disease causes restrictive physiology.

  • C. Alcoholic dilated cardiomyopathy

    Alcoholic cardiomyopathy gives a dilated, poorly contracting ventricle.

  • D. Hypertensive heart disease

    Hypertensive disease causes concentric hypertrophy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Hemochromatosis or amyloidosis causing restrictive cardiomyopathy. The square-root sign reflects rapid early filling that halts abruptly because of a stiff ventricle.

Why is "Aortic stenosis" not the answer?

Aortic stenosis causes pressure overload with a gradient across the valve.

Why is "Alcoholic dilated cardiomyopathy" not the answer?

Alcoholic cardiomyopathy gives a dilated, poorly contracting ventricle.

Why is "Hypertensive heart disease" not the answer?

Hypertensive disease causes concentric hypertrophy.

What concept does this question test?

It tests Cardiology: restrictive cardiomyopathy in General Medicine. Amyloidosis, haemochromatosis, sarcoidosis and endomyocardial fibrosis are classic causes. In amyloid, wall thickness is usually increased with low voltage on ECG.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: restrictive cardiomyopathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.