skip to main content

Hypertrophic Cardiomyopathy — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiologyHypertrophic CardiomyopathyRACP Adult Medicine

A 25-year-old man presents with exertional syncope and a harsh systolic murmur at the left sternal edge that increases with Valsalva and standing, and decreases with squatting. ECG shows LVH with deep Q waves in lateral leads. Echo shows asymmetric septal hypertrophy (18 mm) with systolic anterior motion of the mitral valve and LVOT gradient of 45 mmHg. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Hypertrophic obstructive cardiomyopathy

Exertional syncope with a murmur that increases with reduced preload (Valsalva, standing) and decreases with increased preload (squatting), ASH, SAM of the mitral valve, and dynamic LVOT obstruction is diagnostic of HOCM. First-line treatment is beta-blockers. ICD is indicated for those at high risk of sudden cardiac death. Mavacamten is a newer targeted therapy.

Reference: CSANZ – 2024 – HCM Guidelines; ESC 2023 Cardiomyopathy Guidelines