78-year-old Man in Medicine / Internal Medicine — 78yo Man | Cardiology | SMLE Q#18719
SMLE Question #18719
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: March 2026
A 78-year-old man has 6 months of progressive exertional dyspnea, orthopnea requiring three pillows, and mild bilateral ankle swelling. He has long-standing hypertension. Examination shows bibasilar crackles, elevated jugular venous pressure, and bilateral pitting edema. Transthoracic echocardiography shows concentric left ventricular hypertrophy, left ventricular ejection fraction 60%, and no significant valvular disease. What is the most likely diagnosis?
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