Clinical question of the week: HCM part 1

A 35 year old patient presented to the emergency department complaining of one episode of syncope while walking. He does not remember details of the episode, but he mentioned full recovery only a couple of minutes after the event. He reported no known diseases, no smoking, drinking or drug use. His family history included an older brother who died suddenly while sleeping at age 38. On physical examination the heart rate was 66 bpm, BP was 140/92 mmHg, respiratory rate 14, temperature 36.2oC. SatO2:97%. Lungs were clear. Heart auscultation a systolic murmur (++/4) was noted on the left sternal border. The ECG showed LV hypertrophy. On echocardiogram a hypertrophic cardiomyopathy (HCM) with a septal thickness of 35 mm was found. The aortic outflow gradient had a peak of 45 mmHg. Aortic and mitral valves were normal. LV ejection fraction was normal.
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums