MCQ 7

A 50-year-old male is being evaluated in the cardiology office after his 20-year-old son had a syncopal episode during the college football game and was diagnosed with hypertrophic cardiomyopathy. The patient denies any symptoms, including chest pain, shortness of breath with any physical activity such as jogging and swimming. No significant family history of sudden cardiac death, arrhythmias, and any other significant heart disease. The patient takes no medications besides multivitamins. On physical exam patient is afebrile, blood pressure 130/70 mmHg, respiratory rate is 14 breaths pm, and pulses 80 bpm. On auscultation, normal S1 and S2 with no murmurs noticed. Twelve-lead EKG showed normal sinus rhythm with no acute ST-T changes. Echocardiogram showed an ejection fraction of 50% with normal ventricular function, and no valvular abnormality was found. When should this patient next be screened for hypertrophic cardiomyopathy?

A. In 1 year
B. In 2 years
C. In 5 years
D. No further screening is required
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𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚

𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚 in Patient with AF and acute IS/TIA European Heart Association Guideline recommends: • 1 days after TIA • 3 days after mild stroke • 6 days after moderate stroke • 12 days after severe stroke Early anticoagulation can decrease a risk of recurrent stroke and embolic events but may increase a risk of secondary hemorrhagic transformation of brain infarcts. The 1-3-6-12-day rule is a known consensus with graded increase in delay of anticoagulation between 1 and 12 days after onset of ischemic stroke or transient ischemic attack(TIA), according to neurological severity based on European expert opinions. However, this rule might be somewhat later than currently used in a real-world practical setting.

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