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Exercise Cardiac Output — FRCA Primary MCQ

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HardPhysiology - CardiovascularExercise Cardiac OutputFRCA Primary

During dynamic exercise, cardiac output rises substantially despite a shortening diastolic filling time. Which combination best supports the rise in stroke volume in a healthy adult?

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Correct answer: B — Muscle-pump venous return and sympathetic augmentation of contractility

The best answer is “Muscle-pump venous return and sympathetic augmentation of contractility”. The skeletal-muscle pump and venoconstriction augment venous return, while sympathetic activation increases contractility; together they support stroke volume as heart rate rises. Increased venous compliance or pooling would lower stressed volume and preload. Reduced end-systolic elastance and increased afterload oppose ejection rather than support the exercise increase in cardiac output.

Reference: RCoA, Primary FRCA syllabus: https://www.rcoa.ac.uk/sites/default/files/documents/2026-01/Primary-FRCA-Syllabus.pdf; Exercise Dynamics in Secondary Mitral Regurgitation: https://pmc.ncbi.nlm.nih.gov/articles/PMC5245732/