Rosh Internal Medicine Boost Practice Exam

Heart failure with preserved ejection fraction (HFpEF) is characterized by a left ventricular ejection fraction that is typically 50% or greater. In this condition, the heart is able to contract effectively but has difficulty relaxing, leading to impaired filling of the ventricles. This results in symptoms of heart failure despite the ejection fraction remaining within a normal range. HFpEF is often associated with conditions such as hypertension, obesity, and diabetes, which contribute to changes in the heart muscle and its ability to relax. Patients with HFpEF generally present with symptoms such as shortness of breath, fatigue, and fluid retention, similar to those seen in other types of heart failure, but the underlying pathophysiology is distinctly different. While heart failure with reduced ejection fraction (HFrEF) is indicated by an ejection fraction less than 40%, and congestive heart failure is a term used to describe the clinical syndrome without specifying the ejection fraction, HFpEF specifically highlights the preservation of ejection fraction while addressing the diastolic dysfunction present in these patients.