American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a common symptom of both peripartum cardiomyopathy and heart failure?

1. Shortness of breath

2. Persistent coughing

3. Chest pain

4. Dizziness

The correct answer is: Shortness of breath

Shortness of breath is a prominent symptom in both peripartum cardiomyopathy and heart failure because both conditions can lead to an increase in fluid accumulation and a decrease in the heart's ability to pump effectively. In heart failure, this occurs due to various underlying cardiac issues, resulting in congestion in the lungs and inadequate blood flow to meet the body's demands. In peripartum cardiomyopathy, which is a form of heart failure that occurs during the last month of pregnancy or within five months after delivery, a similar mechanism is at play. The stress and changes in cardiovascular dynamics associated with pregnancy exacerbate the heart's inability to function properly, often leading to dyspnea (shortness of breath) as a key symptom. Other symptoms such as persistent coughing, chest pain, and dizziness can occur but are more specific to certain types or causes of heart conditions. For example, persistent coughing might indicate pulmonary congestion but is not as universally common in both conditions as shortness of breath. Chest pain may be related to various cardiac or non-cardiac conditions and is less characteristic of heart failure. Dizziness can also arise in heart failure, especially with orthostatic changes, but it is not as definitive a symptom as shortness of breath in