Heart failure with preserved ejection firaction-

Ans. is 'b' i.e., Restrictive cardiomyopathy o Diastolic heart failure (DHF) is a clinical syndrome in which patients have:Symptoms and signs of heart failure (HF)Normal or near normal left ventricular (L Vi ejection fraction (EF)Normal or near normal L V volume,, and evidence of diastolic dysfunction (e.g., abnormal pattern ofL Vfilling and elected filling pressures).o By contrast, systolic heart failure (SHE) is characterized by increased L V volume and reduced EF.o Among all patients with HF, as many as half have a normal or near normal LVEF.o This condition has been termed "heart failure with normal ejection fraction " (HFNEF) or"heart failure with preserved ejection fraction " (HF-PEFEtiologies of Heart FailureDepressed Ejection Fraction (<40%)o Coronary artery diseaseMyocardial infarctionaMyocardial ischemiaaoChronic pressure overloadHypertensionaObstructive valvular diseaseao Chronic volume overloadRegurgitant valvular diseaseIntracardiac- (left-to-right) shuntingExtracardiac shuntingo Nonischemic dilated cardiomyopathyFamilial/genetic, disordersInfiltrative disorders3o Toxic/drug induced damageMetabolic disorder3Viralo Chagas diseaseo Disorders of rate and rhythmChronic tachyarrhythmiasChronic tachyarrhythmiasPreserved Ejection Fraction (>40-50%)o Pathologic hypertrophy# Primary (hypertrophic cardiomyopathies)o Agingo Restrictive cardiomyopathy# Infiltrative disorders (amyloidosis sarcoiodosis)o Fibrosiso Endomyocardial disordersPulmonary Heart DiseaseCor pulmonalePulmonary vascular disorders High-Output States# Metabolic disordersThyrotoxicosisNutritional disorders (beriberi)o Excessive blood-flow requirementsSystemic arteriovenous shuntingChronic anemia