The ECG shown on page 12 (Figure 2) is that of a 26-year-old patient who collapsed while playing football.

a) Describe the ECG abnormalities. (5% marks)

b) Give the likely diagnosis. (5% marks)

c) What other features would you look for on examination of the cardiovascular system? (20% marks)

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College answer

a)    LVH with strain pattern. 
 
b)    Hypertrophic obstructive cardiomyopathy (HOCM). 
 
c)    Late systolic murmur / midsystolic murmur at left lower sternal edge and apex (due to LVOT obstruction).  Pansystolic murmur at apex due to mitral regurgitation (LVOT obstruction lead to pressure effect on anterior mitral valve leaflet causing systolic anterior motion and mitral regurgitation). 
 

Discussion

Image stolen from the LITFL LVH page.