Learning Cardiology

 Q. Mavacamten was recently assessed and found to be useful in which of the following disease? A. DCMP B. HOCM C. Coronary artery disease with mitral regurgitation D. Amyloidosis Answer: B. HOCM Mavacamten is a medication that relaxes the heart muscle and treats obstructive hypertrophic cardiomyopathy (HCM). It is a small-molecule inhibitor of cardiac myosin that reduces myocardial contractility and improves myocardial energetics.

1. What is the diagnosis? 2. What is the name of this sign? Answer 1: Hypertrophic obstructive cardiomyopathy (HOCM) Answers 2: Brockenbrough-Braunwald-Morrow sign Explanation: There is a decrease in pulse pressure and increase in left ventricular outflow tract gradient after the ventricular ectopic beat in HOCM patients. This phenomenon is known as Brockenbrough-Braunwald-Morrow phenomenon or sign.  

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)

Q. Most common cause of sudden cardiac death in young athletes is? A. Hypertrophic obstructive cardiomyopathy B. Myocardial infarction C. Coronary artery anomalies D. Myocarditis Answer: Option A Explanation: Most common cause of sudden cardiac death in young patients (less than 35 years) is HOCM followed by coronary artery anomalies. Whereas, most common cause of SCD in old patients is coronary artery disease and myocardial infarction.