Which of the following is not a typical finding in hypertrophy of the left ventricle?

• A. Increased left ventricular wall thickness
• B. Decreased ejection fraction
• C. Enhanced diastolic filling
• D. Left atrial enlargement

Answer: (C)

In the context of left ventricular hypertrophy, enhanced diastolic filling is not typically observed. During hypertrophy, the thickening of the left ventricular wall can lead to decreased compliance of the ventricle. This decreased compliance means that the ventricle may not fill as easily during diastole, resulting in impaired diastolic filling.

In contrast, increased left ventricular wall thickness is a hallmark of ventricular hypertrophy as the heart muscle adapts to increased workload, often from conditions like hypertension or aortic stenosis. Decreased ejection fraction is more commonly associated with dilated cardiomyopathy; however, in the early stages of hypertrophy, particularly with pressure overload, the ejection fraction can remain within normal limits, but as the condition progresses, it can become impaired. Left atrial enlargement frequently occurs due to increased pressure in the left ventricle, consequently leading to elevated pressures in the left atrium because of the impaired forward flow.

Thus, the typical physiological adaptations seen in left ventricular hypertrophy do not support the idea of enhanced diastolic filling, making that choice correct in this context.