A 22-year-old college wrestler comes for a sports physical examination. He tells you that he often feels excessively short of breath during practice and even has had chest pain that resolves with rest. He reports experiencing a syncopal episode 3 months ago while running a marathon. While taking the family history he tells you that his father died of ‘earlier-than-normal age’ sudden death. You send the patient for an echocardiogram, which reveals a hypertrophic heart, a thickened interventricular septum and a functional left ventricular outflow obstruction durings systole. You suspect hypertrophic obstructive cardiomyopathy in this young man. Of the following, where would you expect to hear the murmur with the loudest intensity?
Of the following, which genetic disorder is characterized by hypertrophic obstructive cardiomyopathy?
A 22-year-old college wrestler comes for a sports physical examination. He tells you that he often feels excessively short of breath during practice and even has had chest pain that resolves with rest. He reports experiencing a syncopal episode 3 months ago while running a marathon. While taking the family history he tells you that his father died of ‘earlier-than-normal age’ sudden death. Later, you send the patient for an echocardiogram, which reveals a hypertrophic heart, a thickened interventricular septum and a functional left ventricular outflow obstruction durings systole. Which of the following would you expect as you auscultate his heart?
A 22-year-old college wrestler comes for a sports physical examination. He tells you that he often feels excessively short of breath during practice and even has had chest pain that resolves with rest. He reports experiencing a syncopal episode 3 months ago while running a marathon. While taking the family history he tells you that his father died of ‘earlier-than-normal age’ sudden death. You send the patient for an echocardiogram, which reveals a hypertrophic heart, a thickened interventricular septum and a functional left ventricular outflow obstruction durings systole. As you conclude the visit, the patient expressed his desire to continue participation in competitive sports. According to the 36th Bethesda Conference and European Society Cardiology, which of the following is the right recommendation for this patient concerning his sports participation?
Of the following, which cardiac condition is associated with sudden cardiac death in young competitive athletes?
A 22-year-old college wrestler comes for a sports physical examination. He tells you that he often feels excessively short of breath during practice and even has had chest pain that resolves with rest. He reports experiencing a syncopal episode 3 months ago while running a marathon. While taking the family history he tells you that his father died of ‘earlier-than-normal age’ sudden death. You send the patient for an echocardiogram, which reveals a hypertrophic heart, a thickened interventricular septum and a functional left ventricular outflow obstruction durings systole. You suspected hypertrophic obstructive cardiomyopathy in this patient. You wanted to make sure that your auscultatory findings are consistent with your suspicions. Of the following which bedside maneuver increases the intensity of murmur of this disorder?
A 22-year-old college wrestler comes for a sports physical examination. He tells you that he often feels excessively short of breath during practice and even has had chest pain that resolves with rest. He reports experiencing a syncopal episode 3 months ago while running a marathon. While taking the family history he tells you that his father died of ‘earlier-than-normal age’ sudden death. You send the patient for an echocardiogram, which reveals a hypertrophic heart, a thickened interventricular septum and a functional left ventricular outflow obstruction durings systole. Of the following, which is the most common gene mutation found in this disorder?
A 54-year-old male presents to the emergency room complaining of chest discomfort that started while he was landing the Boeing 747 plane in the airport this morning. He felt some lightheadedness as he taxied the plane. This is the fourth attack of chest discomfort in the last 6 months. It used to respond well to nitroglycerin but the effectiveness of nitroglycerin decreased over the weeks. Over the months, he has had several visits to the emergency department for this reason. A nuclear stress test performed last month gave an indeterminate result. Serum troponin was elevated once but not after every episode of chest discomfort. He is a commercial pilot for a major airline. He smokes one pack of cigarettes a day but drinks occasionally, in his words, ‘only on special occasions’. Of the following, what is the most important step in the management of this patient?
