skip to main content

Cardiovascular drift — MRCP Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardExercise PhysiologyCardiovascular driftMRCP Part 1

An asymptomatic 24-year-old elite rower has anterior T-wave inversion and maximal LV wall thickness of 14 mm. Which echocardiographic pattern would most strongly favour physiological athlete remodelling over hypertrophic cardiomyopathy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Proportionate LV cavity enlargement with preserved diastolic function

The best answer is “Proportionate LV cavity enlargement with preserved diastolic function”. Athlete remodelling is generally proportionate: increased wall thickness accompanies an enlarged cavity, with preserved or enhanced filling and no pathological obstruction. HCM is more likely with a relatively small cavity, impaired diastolic function, regional hypertrophy, abnormal strain, left atrial enlargement or systolic anterior motion and an outflow gradient. No single measurement is definitive, especially in the grey zone, but the integrated proportional-remodelling pattern is the strongest physiological discriminator among these choices.

Reference: BSE 2025 guideline: echocardiography in young athletes: https://pmc.ncbi.nlm.nih.gov/articles/PMC11907977/