Cardiology: intra-aortic balloon pump contraindication: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: intra-aortic balloon pump contraindication

Sample item

An intra-aortic balloon pump is being considered in a patient with cardiogenic shock. In which coexisting condition is it contraindicated?

ARefractory unstable angina awaiting angiographyBAcute mitral regurgitation from papillary muscle ruptureCSignificant aortic regurgitationDPost-infarction ventricular septal rupture

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Significant aortic regurgitation

The balloon inflates in diastole, which would worsen regurgitation across an incompetent aortic valve and overload the left ventricle. It helps in acute mitral regurgitation and septal rupture by lowering afterload, and it supports coronary perfusion in refractory ischaemia.

Option by option

A. Refractory unstable angina awaiting angiography
The pump raises diastolic coronary perfusion and is an accepted bridge in refractory ischaemia.
B. Acute mitral regurgitation from papillary muscle rupture
Afterload reduction by the pump reduces mitral regurgitant volume, so it is helpful here.
C. Significant aortic regurgitation (correct)
Correct. Diastolic inflation increases the regurgitant volume across an incompetent aortic valve.
D. Post-infarction ventricular septal rupture
The pump lowers afterload and left-to-right shunting, so it is used to stabilise septal rupture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Significant aortic regurgitation. The balloon inflates in diastole, which would worsen regurgitation across an incompetent aortic valve and overload the left ventricle.

Why is "Refractory unstable angina awaiting angiography" not the answer?

The pump raises diastolic coronary perfusion and is an accepted bridge in refractory ischaemia.

Why is "Acute mitral regurgitation from papillary muscle rupture" not the answer?

Afterload reduction by the pump reduces mitral regurgitant volume, so it is helpful here.

Why is "Post-infarction ventricular septal rupture" not the answer?

The pump lowers afterload and left-to-right shunting, so it is used to stabilise septal rupture.

What concept does this question test?

It tests Cardiology: intra-aortic balloon pump contraindication in General Medicine. It helps in acute mitral regurgitation and septal rupture by lowering afterload, and it supports coronary perfusion in refractory ischaemia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: intra-aortic balloon pump contraindication?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.