Our Patient' Treatment
Our patient was started on a beta adrenergic blocker. The dose was gradually increased based upon heart rate and blood pressure response. A defibrillator was implanted. He has continued to restrict his physical activity and has remained asymptomatic.
Our patient was counseled regarding screening and exercise. He was told that his first degree family relatives should be screened for the presence of hypertrophic cardiomyopathy with an ECG and echocardiogram. Since, hypertrophic cardiomyopathy may not manifest itself in some individuals until later in life, serial echoes of children of patients should be performed beginning at age twelve or at the time of growth spurts or evidence of puberty. A periodic ECG is recommended for the patient's adolescent first degree relatives with no evidence of hypertrophy on echo. Genetic counseling of the patient was also strongly encouraged. Future genetic testing of the patient and family members are a consideration, though not essential in most instances. Finally, our patient was advised not to participate in strenuous physical activity, based on the significant risk of sudden death in individuals with hypertrophic cardiomyopathy during strenuous exertion.