Certified Registered Nurse Anesthetist (CRNA) Practice Exam

Which symptom is associated with systolic heart failure?

1. Normal ejection fraction

2. Enlarged heart

3. Normal heart size

4. Normal stroke volume

The correct answer is: Enlarged heart

Systolic heart failure, often referred to as heart failure with reduced ejection fraction, is characterized by the heart's inability to pump blood effectively during the contraction phase (systole). One of the physiological changes that occur in response to this impaired pumping ability is an enlargement of the heart, particularly the left ventricle. This enlargement, or dilation, occurs as the heart struggles to maintain adequate blood flow despite decreased contractility. In systolic heart failure, the ejection fraction, which measures the percentage of blood ejected from the heart with each contraction, is typically reduced. Therefore, a normal ejection fraction or normal stroke volume is not associated with this condition. Moreover, heart size is often not normal, as individuals with systolic heart failure frequently experience hypertrophy or dilation of the heart chambers due to the increased workload and compensatory mechanisms. The enlargement of the heart serves as a compensatory mechanism, allowing the heart to try to increase its output. However, this compensation eventually leads to further complications and worsens heart function over time. Thus, the association of an enlarged heart with systolic heart failure is a key characteristic that highlights the underlying pathophysiology of this condition.