A 22-year-old man presents for evaluation of his - darkhorse

[ArchivalUser]

A 22-year-old man presents for evaluation of his
hypertrophic cardiomyopathy (HCM) and considers
whether to undergo placement of an ICD. All of the
following characteristics would indicate an increased
risk for sudden cardiac death and indication to place
an ICD, except:
a) Unexplained syncope.
b) Left ventricular hypertrophy >30 mm.
c) Nonsustained ventricular tachycardia on Holter
monitoring.
d) Resting left ventricular outflow obstruction.
e) Family history of HCM-related sudden cardiac
death in first-degree relative.

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Hypertrophic cardiomyopathy (HCM) is a genetic cardiac
disorder that is the leading cause of sudden cardiac death
(SCD) in young people. Four risk factors have been identified
that increase the risk of SCD in these patients. These
are massive left ventricular hypertrophy > 30 mm, history
of HCM-related SCD in a first-degree relative, nonsustained
ventricular tachycardia on Holter monitoring, and
unexplained syncope not thought to be vasovagal.
Outflow obstruction has not been shown to increase the
risk of SCD independently. If any of these risk factors are
present, then placement of an ICD for primary prevention
should be further evaluated.