Hypertrophic cardiomyopathy

Bullking up

Step 1: View clinicals

A 30 year old man presents after fainting while jogging. Immediately prior to losing consciousness, he felt light-headed and experienced palpitations. He recovered spontaneously after a few seconds and appeared completely well afterwards. No other symptoms were present. He had never experienced such episodes before, and his medical and surgical histories are unremarkable. There is no family history of heart disease or sudden death.


Step 2: Order all relevant investigations

Random blood glucose

The random blood glucose is 150 mg/dl

Arterial Blood Gases

pO2: 95 mmHg pCO2: 37 mmHg saO2: 99% pH: 7.39 HCO3: 24 mmol/l

ECG

The ECG is only significant for left ventricular hypertrophy.

Echocardiogram

There is marked hypertrophy of the left ventricle (LV), asymmetric septal thickening, and systolic anterior motion of the anterior leaflet of the mitral valve. The LV ejection fraction is > 70%, while the LV outflow tract gradient is ~60 mmHg.


Step 3: Select appropriate management

Aspirin
Beta-blockers
ICD implantation
Prophylactic antibiotics


Score: ★★☆