Which condition is listed as an LVAD indication?

• A. Recurrent congestive heart failure
• B. Myocardial infarction with preserved EF
• C. Atrial fibrillation without heart failure
• D. Hypertensive emergency without heart failure

Answer: (A)

Left ventricular assist devices are placed for advanced heart failure when the left ventricle can’t pump effectively despite optimal medical therapy. The scenario described as recurrent congestive heart failure best fits this situation because repeated decompensation and hospitalizations reflect progression to end‑stage disease where mechanical circulatory support can help maintain systemic perfusion and organ function, either while awaiting transplant or as long‑term (destination) therapy.

The other scenarios don’t indicate a need for an LVAD. Myocardial infarction with preserved ejection fraction means the left ventricle’s pumping function is still adequate; an LVAD isn’t indicated unless there’s severe systolic failure. Atrial fibrillation without heart failure does not involve pump failure requiring ventricular support, and a hypertensive emergency without heart failure is a vascular issue, not a scenario where the ventricle needs mechanical unloading.