July 26th, 2020
A 65-year-old man comes to the physician with a 6-month history of shortness of breath, initially with exertion, but now also at night and when lying down. Examination shows jugular venous distention. Crackles are heard at both lung bases. There is 2+ pitting edema of the lower legs and ankles. Echocardiography shows a left ventricular ejection fraction of 65%. The left ventricular cavity is small with concentric hypertrophy. Which of the following is the most likely cause of her heart failure?