# The patient's heart demonstrates ______ filling pattern on echocardiogram, indicating severe diastolic dysfunction.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168392  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The patient's heart demonstrates ______ filling pattern on echocardiogram, indicating severe diastolic dysfunction.

## 보기

1. restrictive **✔ 정답**
2. constrictive
3. impaired
4. abnormal
5. delayed

**정답: 1**

## 해설

A restrictive filling pattern seen on echocardiogram indicates severe diastolic dysfunction, where the ventricle becomes stiff and resistant to filling. This pattern shows rapid early filling followed by minimal late filling, characteristic of restrictive cardiomyopathy.

## 임상 시나리오

Diastolic Dysfunction:
- Grades: I (mild), II (moderate), III (severe/restrictive), IV (irreversible)
- Echocardiographic patterns:
* E/A ratio > 2
* Decreased deceleration time (DT < 160ms)
* Increased E velocity
* Reduced A velocity

Restrictive Filling Pattern:
- Hallmarks:
* Rapid early filling (high E wave)
* Reduced late filling (low A wave)
* Short deceleration time
* High E/e' ratio (>15)

Common Causes:
- Amyloidosis
- Hemochromatosis
- Sarcoidosis
- Radiation therapy
- Constrictive pericarditis

Clinical Features:
- Elevated filling pressures
- Reduced cardiac output
- Exercise intolerance
- Dyspnea
- Peripheral edema

Treatment Approaches:
- Diuretics
- ACE inhibitors
- Beta blockers
- Treatment of underlying cause
- Heart failure management

## 핵심 개념

- **restrictive** — A condition where the heart muscle becomes stiff and resistant to normal filling, characterized by rapid early filling followed by minimal late filling during diastole
- **constrictive** — A condition where the heart is compressed or squeezed by the surrounding tissue, typically due to inflammation or scarring of the pericardium
- **impaired** — A general term indicating compromised or reduced function, not specific to any particular filling pattern
- **abnormal** — A non-specific term indicating deviation from normal cardiac filling patterns without specifying the type of dysfunction
- **delayed** — A pattern where cardiac filling occurs later than normal timing, but does not specifically indicate the severe diastolic dysfunction pattern

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