A previously healthy 19-year-old man is brought to the emergency department by his girlfriend after briefly losing consciousness. He passed out while moving furniture into her apartment. She said that he was unresponsive for a minute but regained consciousness and was not confused. The patient did not have any chest pain, palpitations, or difficulty breathing before or after the episode. He has had episodes of dizziness when exercising at the gym. His blood pressure is 125/75 mm Hg while supine and 120/70 mm Hg while standing. Pulse is 70/min while supine and 75/min while standing. On examination, there is a grade 3/6 systolic murmur at the left lower sternal border and a systolic murmur at the apex, both of which disappear with passive leg elevation. Which of the following is the most likely cause?
AProlonged QT interval
BHypertrophic cardiomyopathy
CMitral valve stenosis
DMitral valve prolapse
EBicuspid aortic valve
A 16-year-old male presents to the cardiologist after passing out during a basketball practice. An echocardiogram confirmed the diagnosis of hypertrophic cardiomyopathy. The cardiologist advises that a pacemaker must be implanted to prevent any further complications and states the player cannot play basketball anymore. Unfortunately, the coach objects to sidelining the player since a big game against their rivals is next week. The coach asks if the pacemaker can be implanted after the game, which of the following steps should the physician take?
APostpone the procedure so the patient can play
BAllow the patient to play and schedule a follow up after the game
CRecommend to the legal guardian that the player stop playing and have the procedure performed
DPerform the procedure immediately so that both the physician and coach's wishes may be fulfilled
EAllow the patient to make the decision regarding his health
A previously healthy 20-year-old man is brought to the emergency department 15 minutes after collapsing while playing basketball. He has no history of serious illness. On arrival, there is no palpable pulse or respiratory effort observed. He is declared dead. The family agrees to an autopsy. Cardiac workup prior to this patient's death would most likely have shown which of the following findings?
ASystolic anterior motion of the mitral valve
BNarrowing of the left main coronary artery
CBicuspid aortic valve
DAsymmetric septal hypertrophy
EVentricular septal defect
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