Hypertrophic cardiomyopathy Quiz: Ace Your Exams
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A 16-year-old boy is evaluated in the pediatric intensive care unit several days after admission. The patient collapsed during a lacrosse game and presented to the emergency department in ventricular fibrillation arrest. He underwent resuscitative measures which were successful, and he was extubated on day three of hospitalization. The patient’s parent died at age 35 of sudden cardiac death. Temperature is 37.0 °C (98.6 °F), pulse is 84/min, respirations are 16/min, blood pressure is 107/75 mm Hg, and oxygen saturation is 100% on room air. On physical exam, a loud systolic ejection murmur is heard at the lower left sternal border and an S4 heart sound is present. Lungs are clear to auscultation bilaterally. Echocardiogram demonstrates left ventricular wall thickness that is more than two standard deviations above the mean for the patient's age, sex, and body surface area, as well as left ventricular outflow tract obstruction. Genetic testing confirms the diagnosis. Which of the following is the best next step in management?
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