Question:
A young patient presents with syncope and a family history of sudden cardiac death in a sibling at a young age. Which of the following statements regarding management is true?
A young patient presents with syncope and a family history of sudden cardiac death in a sibling at a young age. Which of the following statements regarding management is true?
Show Hint
Major risk factors for SCD in HCM include: Prior cardiac arrest, spontaneous sustained VT, family history of premature SCD, unexplained syncope, massive LV hypertrophy ($\geq$ 30 mm), and an abnormal blood pressure response to exercise.
Updated On: Sep 3, 2026
- Avoiding high-intensity sports
- Beta blockers contraindicated
- Digoxin given
- Implantation of a pacemaker
Show Solution
Verified By Collegedunia
The Correct Option is A
Solution and Explanation
Concept:
The clinical scenario of a young patient with syncope and a family history of Sudden Cardiac Death (SCD) in a young sibling is highly suspicious for Hypertrophic Cardiomyopathy (HCM) or an inherited arrhythmogenic disorder (like Long QT syndrome or Brugada syndrome).
The management of these conditions centers around preventing fatal arrhythmias and sudden cardiac death.
Explanation:
• Hypertrophic Cardiomyopathy (HCM) is the leading cause of sudden cardiac death in young athletes.
• The presence of syncope (especially exertional) and a first-degree relative with premature SCD are major high-risk markers for fatal arrhythmias.
• A universally accepted and critical first-line management step for all patients diagnosed with HCM (and other primary arrhythmogenic conditions) is the strict avoidance of competitive, high-intensity sports and strenuous exertion. This removes a major trigger for ventricular fibrillation and SCD.
• Option (B) is incorrect because Beta-blockers are actually the first-line medical therapy for symptomatic HCM. They negative inotropes that increase diastolic filling time and decrease the left ventricular outflow tract (LVOT) gradient.
• Option (C) is incorrect because Digoxin is a positive inotrope. In HCM, increasing cardiac contractility worsens the dynamic LVOT obstruction and is generally contraindicated.
• Option (D) is incorrect because while an Implantable Cardioverter-Defibrillator (ICD) is indicated for primary or secondary prevention in high-risk patients, a simple "pacemaker" is not the primary life-saving device for preventing SCD in this context.
Final answer:
Avoiding high-intensity sports is a true and critical management strategy for preventing sudden cardiac death in such high-risk young patients.
The clinical scenario of a young patient with syncope and a family history of Sudden Cardiac Death (SCD) in a young sibling is highly suspicious for Hypertrophic Cardiomyopathy (HCM) or an inherited arrhythmogenic disorder (like Long QT syndrome or Brugada syndrome).
The management of these conditions centers around preventing fatal arrhythmias and sudden cardiac death.
Explanation:
• Hypertrophic Cardiomyopathy (HCM) is the leading cause of sudden cardiac death in young athletes.
• The presence of syncope (especially exertional) and a first-degree relative with premature SCD are major high-risk markers for fatal arrhythmias.
• A universally accepted and critical first-line management step for all patients diagnosed with HCM (and other primary arrhythmogenic conditions) is the strict avoidance of competitive, high-intensity sports and strenuous exertion. This removes a major trigger for ventricular fibrillation and SCD.
• Option (B) is incorrect because Beta-blockers are actually the first-line medical therapy for symptomatic HCM. They negative inotropes that increase diastolic filling time and decrease the left ventricular outflow tract (LVOT) gradient.
• Option (C) is incorrect because Digoxin is a positive inotrope. In HCM, increasing cardiac contractility worsens the dynamic LVOT obstruction and is generally contraindicated.
• Option (D) is incorrect because while an Implantable Cardioverter-Defibrillator (ICD) is indicated for primary or secondary prevention in high-risk patients, a simple "pacemaker" is not the primary life-saving device for preventing SCD in this context.
Final answer:
Avoiding high-intensity sports is a true and critical management strategy for preventing sudden cardiac death in such high-risk young patients.
Was this answer helpful?
0
0
Top NEET SS Medical Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions
Top NEET SS Cardiology Questions
- An ECG was performed as part of a routine cardiac evaluation. Based on the findings, which of the following is the most likely cause of the abnormal pattern?
- A 21-year-old man presents with sudden onset chest pain. His ECG shows ST-segment elevation in leads II, III, aVF, V5, and V6, and echocardiography reveals concentric left ventricular hypertrophy. What is the most likely cause?
- The following diagram represents which of the following valvular heart diseases?
- Which of the following statements regarding Cardiac Resynchronization Therapy (CRT) is correct?
- A patient with multiple myeloma presents with shortness of breath, and his 2D echocardiogram shows characteristic findings. Which of the following statements is true?
View More Questions
Top NEET SS Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions