What type of heart failure does this describe: The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing shortness of breath.

• A. Left ventricular systolic dysfunction
• B. Left ventricular diastolic dysfunction
• C. Right ventricular diastolic dysfunction
• D. Left atrial dysfunction

Answer: (B)

The scenario describes a problem with filling rather than pumping. When the ventricle is too stiff, it doesn't relax well enough to fill properly during diastole. This reduced compliance raises the pressure inside the left ventricle and, as a result, increases pressure in the left atrium and pulmonary veins. The backup of pressure into the lungs causes pulmonary congestion and shortness of breath.

This is left ventricular diastolic dysfunction, often referred to as heart failure with preserved ejection fraction, where the heart’s ability to pump forward may be preserved but filling is impaired.

Why the other possibilities don’t fit as well: systolic dysfunction involves trouble ejecting blood and a reduced ejection fraction, not primarily filling. Right ventricular diastolic dysfunction would cause systemic (not pulmonary) signs of congestion. Left atrial dysfunction isn’t the common way this pathophysiology is described or diagnosed.