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Hypertrophic cardiomyopathy — RACP Adult Medicine MCQ

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ModerateCardiologyHypertrophic cardiomyopathyRACP Adult Medicine

A 24-year-old man has exertional presyncope and a harsh systolic murmur that increases on standing. His father died suddenly at age 39. ECG shows deep lateral T-wave inversion and high voltages. What is the most appropriate investigation?

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Correct answer: B — Transthoracic echocardiography

The history and dynamic murmur suggest hypertrophic cardiomyopathy, for which echocardiography is the first-line structural test. Exercise testing may later help risk stratification but should not be the initial diagnostic test in a possible inherited cardiomyopathy with syncope. The other imaging options do not assess asymmetric hypertrophy or LV outflow obstruction.

Reference: CSANZ cardiomyopathy guidance; AMH