Question of the Week
For April 26, 2016
A 71-year-old woman presents to the emergency department with acute-onset shortness of breath. She has a history of hypertension but no known cardiac disease.
On examination, she has a respiratory rate of 32 breaths per minute, a heart rate of 110 beats per minute, and a blood pressure of 192/96 mm Hg. Her jugular venous pressure is elevated, but she has no murmurs. She has bibasilar crackles in her lungs. Her lower extremities show symmetrical 1+ edema.
A bedside echocardiogram reveals concentric left ventricular hypertrophy and hyperdynamic wall motion, with an estimated left ventricular ejection fraction of 70%. The patient has no valvular regurgitation, stenosis, or outflow-tract abnormalities.
Which one of the following cardiac conditions is most likely to be the cause of this patient’s dyspnea?