# The heart shows a characteristic ______ phenomenon, where early diastolic filling is rapid but abruptly stops, suggesting restrictive cardiomyopathy.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168408  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The heart shows a characteristic ______ phenomenon, where early diastolic filling is rapid but abruptly stops, suggesting restrictive cardiomyopathy.

## 보기

1. square-root **✔ 정답**
2. dip-and-plateau
3. rapid-filling
4. restrictive
5. constrictive

**정답: 1**

## 해설

The square-root sign or phenomenon describes the characteristic pattern of ventricular filling seen in restrictive cardiomyopathy. It shows rapid early filling that abruptly ceases, creating a "square root" appearance on hemodynamic tracings.

## 임상 시나리오

1. Square Root Sign
- Characteristic hemodynamic pattern in restrictive cardiomyopathy
- Rapid early diastolic filling followed by sudden cessation
- Visible on pressure tracings as √-shaped configuration

2. Restrictive Cardiomyopathy Features
- Impaired ventricular filling
- Normal or decreased ventricular volumes
- Increased filling pressures
- Preserved systolic function

3. Hemodynamic Characteristics
- Elevated right atrial pressure
- "Dip and plateau" pattern in ventricular pressure
- Increased end-diastolic pressure
- Reduced cardiac output

4. Diagnostic Criteria
- Increased E/A ratio >2
- Shortened deceleration time
- Elevated pulmonary artery pressure
- Preserved ejection fraction

5. Clinical Manifestations
- Dyspnea
- Peripheral edema
- Hepatomegaly
- Exercise intolerance
- Fatigue

## 핵심 개념

- **square-root** — A characteristic pattern seen in ventricular pressure tracings during diastole, showing rapid early filling followed by an abrupt plateau, resembling the mathematical square root symbol
- **dip-and-plateau** — A hemodynamic pattern characterized by a rapid early diastolic drop in pressure followed by a plateau phase, typically seen in constrictive pericarditis
- **rapid-filling** — The initial phase of ventricular diastole where blood quickly flows from the atrium to the ventricle due to pressure differences
- **restrictive** — A condition where the heart muscle becomes rigid and less elastic, limiting its ability to fill properly during diastole
- **constrictive** — A condition where the heart's outer covering (pericardium) becomes thickened and fibrotic, limiting cardiac filling

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