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Old 03-05-2013
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Default Therapy or clear for exercise?

A 16 year old boy presents for pre-participation examination prior to athletic training in his college campus. He denies any history of dizziness or palpitations or shortness of breath upon exertion. He denies any syncopal episodes. He denies any family history of Sudden Cardiac Death. Physical examination reveals a systolic murmur that increases with valsalva maneuver. Electrocardiogram reveals changes consistent with lEft ventricular hypertrophy. An echocardiogram reveals asymmetric septal hypertrophy and Systolic Anterior Motion (SAM) of the Anterior Mitral Leaflet. The findings are discussed with patient and he intends to participate in athletics because he does not have any symptoms. Which of the following is the most appropriate next step?

A) Clear the patient for athletic training

B) Start Beta Blocker Therapy

C) Exercise Stress Test

D) Cardiac catheterization

E) Implantable Cardioverter-Defibrillator
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radkur (03-07-2013)

Old 03-06-2013
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B) Start Beta Blocker Therapy
A man doesn't know what he knows until he knows what he doesn't know.
“What is man? He's just a collection of chemicals with delusions of grandeur.”
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Old 03-07-2013
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B since he can't be cleared and the exercise stress test would be more indicated in coronary artery disease related pathologies. The other answers would not help much with this pathology.
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