QuestionSBA
QuestionChoice
Hypertrophic obstructive cardiomyopathy is the commonest cause of sudden cardiac death in young patients. Patients with HOCM also tend to experience exertional dyspnoea and syncope. However, prolonged QT segments are not consistent with the diagnosis of HOCM. Features of HOCM include left ventricular hypertrophy, ST changes including T wave inversion, and deep Q waves.
10003585
e
Hypertrophic obstructive cardiomyopathy (HOCM)
QuestionChoice
There are congenital and acquired causes of long QT syndrome, and this patient's cousin likely has a congenital cause. In long QT syndrome, there is delayed repolarisation of the ventricles which can lead to ventricular tachycardia/torsade de pointes. These tachyarrhythmias can lead to collapse or even sudden death. Long QT syndrome is also associated with seizures and palpitations.
10003581
a
Ventricular tachyarrhythmia
QuestionChoice
Complete heart block can also present with syncopal episodes, and if untreated, can lead to sudden cardiac arrest. However, most causes of heart block are acquired, not genetic. Indeed, most cases of heart block present at older ages.
10003582
b
Complete heart block
QuestionChoice
Strokes are uncommon in teenagers (the patient's cousins passed away in their teens). This patient is also not presenting with the typical features of a stroke.
10003584
d
Stroke
QuestionChoice
This patient does not describe any of the typical symptoms of a pulmonary embolism, such as pleuritic chest pain, dyspnoea, tachycardia and tachypnoea. Furthermore, pulmonary embolism is rare in adolescents.
10003583
c
Pulmonary embolism
Concept
Chapter
2693
4178
Arrhythmias
Topic
134
Cardiology
13263
A 27-year-old female seeks advice after having a 'funny turn'. She fainted for a few minutes and then regained consciousness and has felt fine since. She mentions that two of her maternal first cousins died in their teens while swimming.

An electrocardiogram (ECG) is carried out, which shows a QTc interval of 560ms (reference <460 ms)

What is the most likely cause of her cousins' deaths?
a