A 22 year old man has exertional syncope during sprinting. His uncle died suddenly at age 30. Cardiac examination reveals a harsh systolic murmur at the left sternal border. The murmur becomes louder during the strain phase of the Valsalva maneuver. Which of the following is the most likely diagnosis?
- A)Tricuspid regurgitation
- B)Aortic stenosis
- C)Mitral valve prolapse
- D)Hypertrophic obstructive cardiomyopathyGABARITO
- E)Ventricular septal defect
Explicação
Hypertrophic obstructive cardiomyopathy is correct. Dynamic left ventricular outflow tract obstruction worsens when preload falls, so the murmur becomes louder with Valsalva or standing. The family history of sudden death and exertional syncope are classic clu... Ver explicação completa e trilha adaptativa →