Which of the following is a cardiac effect of malignant hypertension?

• A. Renal failure
• B. Encephalopathy
• C. Myocardial infarction
• D. Retinopathy

Answer: (C)

Malignant hypertension can cause end-organ damage across multiple systems, and the heart is one that can be affected. The extreme elevation in blood pressure dramatically increases afterload and myocardial wall stress, raising the heart’s oxygen demand. If the coronary circulation can’t supply enough oxygen—due to underlying atherosclerosis, microvascular injury, or vasospasm—ischemia can develop and progress to a myocardial infarction.

The other options reflect injury to different organs: renal failure involves the kidneys, encephalopathy involves the brain, and retinopathy involves the eyes. While those are common in malignant hypertension, they are not cardiac events. Therefore, myocardial infarction best represents a cardiac effect in this context.