Heart Failure USMLE Step 1 Practice Question
A 54-year-old man with uncontrolled hypertension presents with progressive exertional dyspnea and hoarseness. Vital signs show BP 168/95 mmHg, HR 102/min, RR 20/min, SpO2 96% on room air. Cardiac examination reveals a high-pitched early diastolic murmur. Chest X-ray demonstrates aneurysmal dilation of the ascending thoracic aorta with a widened mediastinum. Pulmonary examination is clear to auscultation bilaterally. Which mechanism best explains his acute decompensated heart failure?
Answer choices
- AInflammatory thrombosis of small and medium vessels in smokers
- BObliterative endarteritis of the vasa vasorumCorrect answer
- CAtherosclerotic destruction of the infrarenal aorta
- DCystic medial degeneration due to fibrillin defect
- EIntimal tear with blood dissecting along the media
- FLeft ventricular outflow tract obstruction from aneurysmal compression of the aortic root
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.