Best Practice Case Studies-Study Questions (RETURN TO PLAY AFTER CHEST PAIN)

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This document includes multiple-choice study questions related to hypertrophic cardiomyopathy (HCM), its differentiation from an athlete's heart, and the physical examination findings relevant to this condition.<br /><br />For Study Question #1, participants are asked to identify electrocardiogram (ECG) findings typical of hypertrophic cardiomyopathy as opposed to an athlete’s heart. The correct answer, option B, denotes that T-wave inversion and deep Q waves are consistent with HCM. The question further elaborates that incomplete right bundle branch blocks and high T waves are findings more aligned with an “athlete’s heart.” However, deep Q waves and T-wave inversion are not usually seen in athletes, making these signs indicative of HCM, a condition linked with the risk of sudden cardiac death in athletes.<br /><br />The second study question addresses physical examination techniques to identify murmurs associated with HCM. The correct answer, option C, states that a II/VI systolic ejection murmur over the left sternal border resolving during the Valsalva maneuver is likely benign, pointing towards a physiologic flow murmur. It explains that the Valsalva maneuver reduces venous return and decreases the intensity of flow murmurs, but increases left ventricular outflow tract obstruction in HCM, making the murmur more intense in such conditions.<br /><br />These study questions serve as practical examples to differentiate between physiological adaptations in athletes and pathological conditions requiring medical attention. Accurate interpretation of ECG findings and murmur characteristics are crucial for proper assessment and management of athletes potentially at risk for HCM. Further evaluation with cardiac imaging or specialist consultation is suggested if there is any uncertainty.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 07

Topic Cardiac

Keywords

hypertrophic cardiomyopathy

athlete's heart

ECG findings

T-wave inversion

deep Q waves

3rd Edition

systolic ejection murmur

Valsalva maneuver

sudden cardiac death

left ventricular outflow tract obstruction

cardiac imaging

3rd Edition, CASE 07

Cardiac