Cardiology MCQ 54

Q. Which one of following echocardiographic features is an important risk factor for sudden cardiac death in HOCM?
A. Gradient of 30 mmHg across left ventricular outflow tract
B. Septal wall thickness of > 3 cm
C. Systolic anterior motion of mitral valve
D. The presence of severe mitral regurgitation

Answer: B. Septal wall thickness of >3 cm

Explanation:
Most common cause of SCD in young adults during physical activity and overall also is HOCM.
To prevent SCD, Implantable cardioverter defibrillator (ICD) therapy is recommended in patients with
1. Prior cardiac arrest (Class I)
2. Sustained ventricular tachycardia (VT) (Class I)
3. History of SCD in a first-degree relative (Class IIa)
4. Marked LV hypertrophy (Septal thickness more than 3 cm) (Class IIa)
5. Recent unexplained syncope (Class IIa)
6. Nonsustained VT or an abnormal blood-pressure response to exercise (Class IIa)

Comments

ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

High heart rate

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

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