Clinical scenario
A 45-year-old builder with one episode of unexplained syncope has a transthoracic echocardiogram that is suggestive of hypertrophic cardiomyopathy.
Question
Which two of the following features are not associated with a high risk of sudden death?
A History of ventricular tachycardia (VT) or resuscitated ventricular fibrillation
B Recurrent syncope
C Strong family history of sudden death
D Breathlessness on exertion
E Extreme left ventricular hypertrophy (septal thickness >3 cm)
F Non-sustained VT on Holter monitoring
G Syncope while running
H Diagnosis in childhood
I Resting outflow tract gradient >25 mmHg
J BP drops on exercise
Answer:
Two of the features that are not associated with a high risk of sudden death are:
- D. Breathlessness on exertion
- I. Resting outflow tract gradient >25 mmHg
Discussion: Dyspnoea with exertion and resting outflow tract gradient are not associated with an
increased risk of sudden death.
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