A 17-year-old competitive basketball player presents with exertional syncope and dyspnea on exertion. Vital signs show BP 118/76 mmHg, HR 92 bpm, RR 18, and SpO2 98% on room air. Examination reveals a harsh systolic murmur that increases with standing and Valsalva maneuver. Echocardiography demonstrates asymmetric septal hypertrophy with an outflow gradient of 65 mmHg. He denies palpitations. He takes no medications. Which arrhythmic complication most likely explains his sudden cardiac death risk?
- A)Accessory pathway-mediated orthodromic SVT
- B)Multifocal atrial tachycardia due to pulmonary disease
- C)Ventricular tachyarrhythmia arising in a hypertrophied myocardiumGABARITO
- D)Atrial flutter due to right atrial enlargement
- E)Complete heart block due to AV nodal infarction
Explicação
Hypertrophic cardiomyopathy predisposes to malignant ventricular tachyarrhythmias and sudden cardiac death, especially during exertion in young athletes. Myocyte disarray and ventricular hypertrophy create an electrically unstable substrate. Ver explicação completa e trilha adaptativa →