IM
HIV - 01-02-08 12:57
A 22-year-old man with a known family history of hypertrophic obstructive cardiomyopathy (HOCM) presents to the emergency department with an episode of syncope while climbing the stairs to get to his third-floor apartment. He was started on a beta-blocker twelve months ago but continued to have symptoms of dyspnea and lightheadedness. Verapamil was added six months ago, but he still has had persistent symptoms. What would be the next best step in the management of this patient?
(A) Cardiac transplantation
(B) ACE inhibitors
(C) Electrophysiology studies
(D) Surgical myomectomy
(E) Injection of absolute alcohol into the myocardium
HIV - 01-02-08 12:57
A 22-year-old man with a known family history of hypertrophic obstructive cardiomyopathy (HOCM) presents to the emergency department with an episode of syncope while climbing the stairs to get to his third-floor apartment. He was started on a beta-blocker twelve months ago but continued to have symptoms of dyspnea and lightheadedness. Verapamil was added six months ago, but he still has had persistent symptoms. What would be the next best step in the management of this patient?
(A) Cardiac transplantation
(B) ACE inhibitors
(C) Electrophysiology studies
(D) Surgical myomectomy
(E) Injection of absolute alcohol into the myocardium
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#4
Re: IM babbu5508 - 07-07-10 00:46 (D) Surgical myomectomy
(E) Injection of absolute alcohol into the myocardium
hmm...the most benefit is likely to be from surgical myomectomy removing the obstruction
#5
Re: IM bingousmle - 07-12-10 05:37 ACE inhibitors do not have any benefit in HOCM... surgical myomectomy is the best next intervention to consider for symptomatic benefit
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