Daily question Lets get to the heart of the matter this week

[Scott Rand]

A 19 year old female tennis player comes to you for her PPE.  She denies any cardiac symptoms and has always kept up with her peers.  There is no history of heart disease or early death in the family.  Examination is unremarkable except for a systolic ejection murmur that increases with Valsalva and standing, and decreases with fist clenching and squatting. 

 

Which is the most significant predictor of sudden cardiac death in this athlete?

 

A.      Sudden death in her brother

B.      Muscle fiber disarray on biopsy

C.      Septal thickness of >1.8cm

D.      Paroxysmal atrial fibrillation on Holter monitoring

E.       Resting BP 120/75, and BP 95/70 after six minutes of exercise

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Scott E Rand, MD  FAAFP CAQSM

Director, Primary Care Sports Medicine Fellowship

Co Director of Sports Medicine, Houston Methodist Orthopedics and Sports Medicine Willowbrook

Assistant Professor of Clinical Family Medicine  Houston Methodist Academic Institute

Adjunct Assistant Professor of Family and Community Medicine, Texas A&M University

Assistant Professor of Family Medicine in Clinical Medicine  Weill Cornell Medical College.

13802 Centerfield Dr  Suite 300

Houston, TX  77070