Exam 2 HPI Examples Questions with
Accurate Answers
Left-sided HF - ANSWERSMrs. Patel, a 70-year-old woman with a history of
hypertension, presents with a three-week history of worsening shortness of breath,
especially on exertion, and a persistent dry cough that worsens at night. She reports
swelling in her ankles and legs, which has been progressively increasing, and has had
to start sleeping on three pillows due to orthopnea. Mrs. Patel notes decreased exercise
tolerance, often feeling fatigued after minimal activity. Despite taking her prescribed
medications, including an ACE inhibitor, she has noticed a decline in her overall energy
levels and an increase in her abdominal girth.
Right-sided HF - ANSWERSMr. Davis, a 60-year-old male with a history of chronic
obstructive pulmonary disease (COPD) and hypertension, presents with worsening
lower extremity swelling and abdominal distention over the last two months. He reports
a significant increase in his waist circumference and a feeling of fullness in his
abdomen, especially after meals. He experiences discomfort in his right upper quadrant
and has noted a significant decrease in appetite. Mr. Davis also reports nocturia,
awakening multiple times at night to urinate, and acknowledges a weight gain of 8
pounds over the past month despite dietary modifications. His breathing has become
more labored, and he now experiences shortness of breath, even at rest.
DILATED cardiomyopathy - ANSWERSMrs. Garcia, a 55-year-old woman, presents
with progressive fatigue, shortness of breath, and swelling in her legs for the past three
months. She describes a history of recurrent respiratory infections, which she noticed
became more debilitating. She reports decreased exercise tolerance, finding it
increasingly difficult to perform household chores without getting winded. Mrs. Garcia
denies chest pain but has experienced episodes of palpitations and dizziness. She has
a significant past medical history, including uncontrolled hypertension, and has a family
history of heart disease. Despite compliance with her medications, her symptoms have
worsened, prompting her to seek medical attention.
Peripartum cardiomyopathy - ANSWERSMrs. Johnson, a 35-year-old woman, presents
with shortness of breath, swelling in her ankles, and fatigue, which started a month after
giving birth to her third child. She describes a rapid onset of symptoms, initially
attributing them to the demands of caring for her newborn. However, her breathing
difficulties worsened, especially at night, and she noticed a persistent cough. Mrs.
Johnson denies any history of heart disease or hypertension before pregnancy. She has
no significant medical history and is not on any medications. Her symptoms have
prompted her to seek urgent medical care, concerned about her declining health despite
the recent birth of her child.
, HYPERTROPHIC cardiomyopathy (HCM) - ANSWERSMr. Anderson, a 42-year-old
man, presents with recurrent episodes of chest pain and palpitations during physical
activity for the past six months. He reports a family history of sudden cardiac death in
his younger brother. He experiences fatigue and shortness of breath with exertion and
occasional dizziness. He denies any significant medical history, drug use, or recent
infections. Mr. Anderson is concerned about his symptoms and their impact on his daily
life, especially as he has been unable to continue his regular exercise routine due to
these issues.
RESTRICTIVE cardiomyopathy - ANSWERSMrs. Lewis, a 60-year-old woman,
presents with gradually worsening shortness of breath and fatigue over the past year.
She reports swelling in her ankles and abdomen and has noticed a significant decrease
in her exercise tolerance. She denies chest pain but describes a persistent dry cough,
especially at night, and has experienced occasional palpitations. Mrs. Lewis has a
history of amyloidosis, which was diagnosed two years ago, and her symptoms have
intensified recently, leading her to seek medical attention.
ARRHYTHMOGENIC cardiomyopathy (ACM) - ANSWERSMr. Davis, a 35-year-old
man, presents with recurrent palpitations and episodes of lightheadedness for the past
several months. He reports a family history of sudden cardiac death in his father at the
age of 40. He describes occasional chest discomfort during exercise and has noticed
his heart "skipping beats." Mr. Davis denies shortness of breath or swelling but
expresses significant concern about his symptoms, especially after learning about his
family history, which prompted him to seek medical evaluation.
TAKOTSUBO cardiomyopathy - ANSWERSMrs. Walker, a 62-year-old woman,
presents with chest pain and acute shortness of breath following a recent emotional
stressor. She describes a sudden onset of severe chest discomfort radiating to her left
arm, associated with nausea and diaphoresis. Upon further questioning, she reveals
that she recently lost her spouse unexpectedly. Mrs. Walker denies any history of heart
disease or hypertension but reports a history of emotional stressors in her life. Her
symptoms, coupled with her recent emotional distress are prompting her urgent hospital
admission for further evaluation and management.
ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) - ANSWERSMr.
Johnson, a 58-year-old man with a history of hypertension, diabetes, and
hyperlipidemia, presents with a pressing, squeezing chest pain radiating to his jaw and
left arm that started 30 minutes ago. He describes associated shortness of breath and
diaphoresis. The pain was exacerbated by physical activity and relieved by rest. Mr.
Johnson reports a sedentary lifestyle, a high-fat diet, and a family history of heart
disease. His symptoms, concerning acute coronary syndrome, prompted him to seek
immediate medical attention, fearing a heart attack.
ISCHEMIC HEART DISEASE - ANSWERSMr. Rodriguez, a 62-year-old man, presents
with recurrent episodes of chest pain for the past six months. He describes the pain as
a heaviness and pressure in his chest, typically occurring during physical exertion and
Accurate Answers
Left-sided HF - ANSWERSMrs. Patel, a 70-year-old woman with a history of
hypertension, presents with a three-week history of worsening shortness of breath,
especially on exertion, and a persistent dry cough that worsens at night. She reports
swelling in her ankles and legs, which has been progressively increasing, and has had
to start sleeping on three pillows due to orthopnea. Mrs. Patel notes decreased exercise
tolerance, often feeling fatigued after minimal activity. Despite taking her prescribed
medications, including an ACE inhibitor, she has noticed a decline in her overall energy
levels and an increase in her abdominal girth.
Right-sided HF - ANSWERSMr. Davis, a 60-year-old male with a history of chronic
obstructive pulmonary disease (COPD) and hypertension, presents with worsening
lower extremity swelling and abdominal distention over the last two months. He reports
a significant increase in his waist circumference and a feeling of fullness in his
abdomen, especially after meals. He experiences discomfort in his right upper quadrant
and has noted a significant decrease in appetite. Mr. Davis also reports nocturia,
awakening multiple times at night to urinate, and acknowledges a weight gain of 8
pounds over the past month despite dietary modifications. His breathing has become
more labored, and he now experiences shortness of breath, even at rest.
DILATED cardiomyopathy - ANSWERSMrs. Garcia, a 55-year-old woman, presents
with progressive fatigue, shortness of breath, and swelling in her legs for the past three
months. She describes a history of recurrent respiratory infections, which she noticed
became more debilitating. She reports decreased exercise tolerance, finding it
increasingly difficult to perform household chores without getting winded. Mrs. Garcia
denies chest pain but has experienced episodes of palpitations and dizziness. She has
a significant past medical history, including uncontrolled hypertension, and has a family
history of heart disease. Despite compliance with her medications, her symptoms have
worsened, prompting her to seek medical attention.
Peripartum cardiomyopathy - ANSWERSMrs. Johnson, a 35-year-old woman, presents
with shortness of breath, swelling in her ankles, and fatigue, which started a month after
giving birth to her third child. She describes a rapid onset of symptoms, initially
attributing them to the demands of caring for her newborn. However, her breathing
difficulties worsened, especially at night, and she noticed a persistent cough. Mrs.
Johnson denies any history of heart disease or hypertension before pregnancy. She has
no significant medical history and is not on any medications. Her symptoms have
prompted her to seek urgent medical care, concerned about her declining health despite
the recent birth of her child.
, HYPERTROPHIC cardiomyopathy (HCM) - ANSWERSMr. Anderson, a 42-year-old
man, presents with recurrent episodes of chest pain and palpitations during physical
activity for the past six months. He reports a family history of sudden cardiac death in
his younger brother. He experiences fatigue and shortness of breath with exertion and
occasional dizziness. He denies any significant medical history, drug use, or recent
infections. Mr. Anderson is concerned about his symptoms and their impact on his daily
life, especially as he has been unable to continue his regular exercise routine due to
these issues.
RESTRICTIVE cardiomyopathy - ANSWERSMrs. Lewis, a 60-year-old woman,
presents with gradually worsening shortness of breath and fatigue over the past year.
She reports swelling in her ankles and abdomen and has noticed a significant decrease
in her exercise tolerance. She denies chest pain but describes a persistent dry cough,
especially at night, and has experienced occasional palpitations. Mrs. Lewis has a
history of amyloidosis, which was diagnosed two years ago, and her symptoms have
intensified recently, leading her to seek medical attention.
ARRHYTHMOGENIC cardiomyopathy (ACM) - ANSWERSMr. Davis, a 35-year-old
man, presents with recurrent palpitations and episodes of lightheadedness for the past
several months. He reports a family history of sudden cardiac death in his father at the
age of 40. He describes occasional chest discomfort during exercise and has noticed
his heart "skipping beats." Mr. Davis denies shortness of breath or swelling but
expresses significant concern about his symptoms, especially after learning about his
family history, which prompted him to seek medical evaluation.
TAKOTSUBO cardiomyopathy - ANSWERSMrs. Walker, a 62-year-old woman,
presents with chest pain and acute shortness of breath following a recent emotional
stressor. She describes a sudden onset of severe chest discomfort radiating to her left
arm, associated with nausea and diaphoresis. Upon further questioning, she reveals
that she recently lost her spouse unexpectedly. Mrs. Walker denies any history of heart
disease or hypertension but reports a history of emotional stressors in her life. Her
symptoms, coupled with her recent emotional distress are prompting her urgent hospital
admission for further evaluation and management.
ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) - ANSWERSMr.
Johnson, a 58-year-old man with a history of hypertension, diabetes, and
hyperlipidemia, presents with a pressing, squeezing chest pain radiating to his jaw and
left arm that started 30 minutes ago. He describes associated shortness of breath and
diaphoresis. The pain was exacerbated by physical activity and relieved by rest. Mr.
Johnson reports a sedentary lifestyle, a high-fat diet, and a family history of heart
disease. His symptoms, concerning acute coronary syndrome, prompted him to seek
immediate medical attention, fearing a heart attack.
ISCHEMIC HEART DISEASE - ANSWERSMr. Rodriguez, a 62-year-old man, presents
with recurrent episodes of chest pain for the past six months. He describes the pain as
a heaviness and pressure in his chest, typically occurring during physical exertion and
