Bullking up

A 30 year old man presents after fainting while jogging. Immediately prior to losing consciousness, he felt light-headed and experienced palpitations. He recovered spontaneously after a few seconds and appeared completely well afterwards. No other symptoms were present.

He had never experienced such episodes before, and his medical and surgical histories are unremarkable. There is no family history of heart disease or sudden death.

Select Relevant Investigations
Random blood glucose

Performed

The random blood glucose is 150 mg/dl
Arterial Blood Gases

Performed

pO2: 95 mmHg
pCO2: 37 mmHg
saO2: 99%

pH: 7.39
HCO3: 24 mmol/l
ECG

Performed

The ECG is only significant for left ventricular hypertrophy.
Echocardiogram

Performed

There is marked hypertrophy of the left ventricle (LV), asymmetric septal thickening, and systolic anterior motion of the anterior leaflet of the mitral valve.
The LV ejection fraction is > 70%, while the LV outflow tract gradient is ~60 mmHg.

Select Relevant Management
Aspirin
Beta-blockers
ICD implantation
Prophylactic antibiotics