5th July 2026

A 45-year-old woman presents with increasing shortness of breath and fatigue

A 45-year-old woman presents with increasing shortness of breath and fatigue. She mentions her father passed away unexpectedly in his early 50s due to heart failure. On examination, bilateral crackles are heard in her lungs, and chest X-ray shows an enlarged heart. Echocardiogram reveals severe left ventricular dilation and reduced ejection fraction. Laboratory tests show elevated BNP levels. What is the most significant risk factor contributing to this patient’s condition?

Select the SINGLE most appropriate option from the list below. Select ONE option only.