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Question:

A 44-year-old man presents with 6 months of DOE - now NYHA Class II. On exam, his BP is 99/70, P 70, and JVP 12 cm. There was no murmur, but an S3 was present. He was found to have an abnormal ECG and an echocardiogram which showed a normal LV cavity size with a severe increase in LV wall thickness (22 mm) and EF 66% but no evidence of an LVO obstruction.

Based upon the ECG, what would be the next step in management for this patient?

ECG

  1. RV biopsy
  2. Send for septal myectomy
  3. Catheterization with isoproterenol infusion
  4. Evaluate for cardiac transplantation

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1.  Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.