شاب عمره ١٩ سنة أُغمي عليه أثناء الجري في التمرين، وعمه توفي فجأة في الثلاثينات. الصدى يظهر اعتلال عضلة القلب الضخامي الانسدادي. الضغط ١١٨/٧٢، والنبض ٦٦. يسأل عن الحياة اليومية. أي نصيحة صحيحة؟

A 19-year-old fainted while running at training; his uncle died suddenly in his thirties. Echo shows hypertrophic obstructive cardiomyopathy. BP 118/72, HR 66. He asks about daily life. Which advice is correct?

1. Avoid dehydration and sudden intense exertion
2. Do intense competitive sport to strengthen the heart
3. Take a daily diuretic to reduce heart size
4. Use nitroglycerin for any chest pain

Answer: A) Avoid dehydration and sudden intense exertion. In HOCM, obstruction worsens when ventricular filling falls, as with dehydration, diuretics and vasodilators, which can cause syncope or sudden death. Treatment is usually beta-blockers or certain calcium channel blockers.