A 22-year-old man with a known family history of hypertrophic obstructive cardiomyopathy (HOCM) presents to the emergency department with an episode of syncope while climbing the stairs to get to his third-floor apartment. He was started on a beta-blocker twelve months ago but continued to have symptoms of dyspnea and lightheadedness. Verapamil was added six months ago, but he still has had persistent symptoms. What would be the next best step in the management of this patient?
(A) Cardiac transplantation (B) ACE inhibitors (C) Electrophysiology studies (D) Surgical myomectomy (E) Injection of absolute alcohol into the myocardium
kashdoc21 Forum Senior
Topics: 52 Posts: 127
08/07/07 - 12:45 AM
#2
Cardiac transplant
khorshid Forum Guru
Topics: 32 Posts: 591
08/07/07 - 06:55 AM
#3
D. Surgical myomectomy, alcohol injection should be in septal arteries, not myocardium.
cirus Forum Guru
Topics: 108 Posts: 740
08/07/07 - 07:17 AM
#4
sorry guys, ur both wrong..
its Injection of absolute alcohol into the myocardium,: as it induces focal necrosis in the septum & so it will loose some of its thickness..
I solved it like u Khorshid, this would be the correct answer if Injection of absolute alcohol into the myocardium was tried & still the case is refractory..
Justice Forum Fanatic
Topics: 117 Posts: 2,324
08/07/07 - 08:30 AM
#5
Where is this Q from? ___________________ Don't live in a town where there are no doctors
cirus Forum Guru
Topics: 108 Posts: 740
08/07/07 - 08:43 AM
#6
Justice wrote: Where is this Q from?
Dr. Conrad Fischer_Questions
doyoudig Forum Guru
Topics: 144 Posts: 613
08/07/07 - 05:54 PM
#7
EE. Funny I just saw a report on the guy that invented this procedure
