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Hypertrophic cardiomyopathy — RCPSC IM MCQ

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HardCardiologyHypertrophic cardiomyopathyRCPSC IM

A 32-year-old man has exertional presyncope and a family history of sudden death at age 38. Echocardiography shows asymmetric septal hypertrophy, resting LV outflow gradient 65 mm Hg and systolic anterior motion of the mitral valve. He is euvolemic and blood pressure is 122/76 mm Hg. What is the most appropriate management?

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Correct answer: A — Start a non-vasodilating beta-blocker and refer for sudden death risk assessment

Obstructive hypertrophic cardiomyopathy is treated initially with negative chronotropic therapy such as a non-vasodilating beta-blocker. Family history and syncope require sudden death risk stratification and possible ICD discussion.

Reference: Canadian Cardiovascular Society hypertrophic cardiomyopathy update