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Hypertrophic cardiomyopathy — RACP Paediatrics MCQ

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HardCardiologyHypertrophic cardiomyopathyRACP Paediatrics

A 16-year-old collapses during a sprint race. His father had a heart 'thickening' condition. Examination reveals a harsh ejection systolic murmur at the left sternal edge that increases with Valsalva manoeuvre. ECG shows LVH with deep Q waves in lateral leads. What is the most likely diagnosis?

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Correct answer: C — Hypertrophic cardiomyopathy

Syncope during exercise with a family history of cardiac disease, a systolic murmur that increases with Valsalva (reducing preload increases outflow tract obstruction), and LVH with deep Q waves on ECG is characteristic of hypertrophic cardiomyopathy (HCM). HCM is the most common cause of sudden cardiac death in young athletes.

Reference: RCH Melbourne – 2023 – Syncope CPG; RACP Paediatric Curriculum – Cardiology