SDS in HOCM

Report:

Sinus rhythm.

Left atrial abnormality .

Left ventricular hypertrophy with ST/T changes.

Comment:

Theoretically, the LAA and the ST/T changes could be a consequence of previous tachyarrhythmia (the "post-tachycardia syndrome"), and the LVH could be spurious, left to depend, as it were, on the precordial voltage criteria alone. The overall changes present are, however, too striking for that.

HOCM is one of the "usual suspects" for the sudden death "syndrome" (SDS) in young subjects. In this case it was diagnosed echocardiographically.

The problem continues to attract interest158,159.

226. 75 year old man two days following emergency repair of bleeding peptic ulcer and truncal vagotomy. There is no clinically apparent heart disease. The changes observed are best explained by (i) his age; (ii) emergency procedure and anæsthesia; (iii) truncal vagotomy; (iv) sedatives and muscle relaxants?

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