Pediatrics

A 14 year old boy came in for pre-sport screening he had systolic murmur, his dad has hypertrophic…

A 14 year old boy came in for pre-sport screening he had systolic murmur, his dad has hypertrophic cardiomyopathy and died at 40 years old. ECG shows long QT.

  1. A Continue sport and do annual ECG
  2. B Give beta blocker and only do sports that require low effort الإجابة الصحيحة
  3. C Restrict sport and consider pacemaker
  4. D It is ok to do sports

الشرح

Core Concept: Long QT syndrome (LQTS) and Hypertrophic Cardiomyopathy (HCM) are inherited conditions that predispose individuals to sudden cardiac death (SCD) during exertion. Beta-blockers and activity restriction are mainstays of therapy.

Clinical Presentation:

  • Syncope, seizures, or sudden cardiac arrest during exercise or emotional stress.
  • Family history of sudden cardiac death at a young age.

Diagnosis:

  • First-line tool: 12-lead ECG (prolonged QTc interval) and Echocardiography (for HCM).
  • Gold standard: Genetic testing to identify specific channelopathy or sarcomere mutations.

Management:

  • Acute: Avoidance of QT-prolonging drugs and correction of electrolyte abnormalities.
  • Long-term/Definitive: Beta-blockers (e.g., nadolol, propranolol) to blunt sympathetic surges. Restriction from competitive and high-intensity sports; only low-effort recreational activities are permitted. ICD placement if high risk.

40 سؤالاً مجاناً مع حساب

الأسئلة المنشورة هنا عيّنة ثابتة. أنشئ حساباً مجانياً لتتدرب على بنك الأسئلة الكامل، مع تحليل أدائك حسب التخصص وصفحة لمراجعة أخطائك.

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