A 75-year-old woman presents with fatigue, edema, and shortness ofbreath. Her physician prescribes a diuretic and a positive inotropic agent.Which of the following changes is primarily responsible for the improve-ment in her condition?a. A reduction in heart rateb. A reduction in heart sizec. An increase in ventricular end-diastolic pressured. An increase in wall thicknesse. An increase in cardiac excitability
Question
A 75-year-old woman presents with fatigue, edema, and shortness ofbreath. Her physician prescribes a diuretic and a positive inotropic agent.Which of the following changes is primarily responsible for the improve-ment in her condition?a. A reduction in heart rateb. A reduction in heart sizec. An increase in ventricular end-diastolic pressured. An increase in wall thicknesse. An increase in cardiac excitability
Solution
The woman's symptoms suggest she may be suffering from heart failure. The diuretic prescribed by her physician would help to reduce the edema (swelling due to fluid accumulation) and the positive inotropic agent would increase the force of her heart's contractions.
The primary change responsible for the improvement in her condition would be:
e. An increase in cardiac excitability
This is because positive inotropic agents work by increasing the force of the heart's contractions, which would help to improve the symptoms of heart failure. This increased force of contraction is due to an increase in cardiac excitability, which means the heart muscle is more responsive to electrical signals that trigger contraction. This would help to improve the woman's fatigue and shortness of breath by improving her heart's ability to pump blood.
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