Rosh Internal Medicine Boost Practice Exam

What is the most likely complication for a 20-year-old who collapses while playing basketball, given a family history of similar incidents?

1. Ventricular tachycardia

2. Cardiac arrest

3. Hypertrophic cardiomyopathy

4. Aortic dissection

The correct answer is: Hypertrophic cardiomyopathy

In a scenario where a young individual collapses during physical activity, particularly given a family history of similar incidents, the most likely complication to consider is hypertrophic cardiomyopathy (HCM). HCM is a genetic condition that often goes undiagnosed until it presents with significant symptoms, like syncope (fainting) or sudden cardiac arrest, particularly in young athletes. Hypertrophic cardiomyopathy is characterized by the thickening of the heart muscle, which can lead to obstructed blood flow and arrhythmias. It is a known cause of sudden cardiac death in young athletes, especially during strenuous activities such as basketball. The family history of similar collapse incidents suggests a hereditary component, supporting the likelihood of a genetic heart condition such as HCM. While other complications like ventricular tachycardia and cardiac arrest could occur as a result of HCM, identifying HCM as the underlying condition helps clarify why the individual might collapse. Aortic dissection typically presents with severe, acute chest pain and is less likely to be associated with a collapse during athletic activity in this age group. Therefore, the presence of HCM correlates directly with the symptoms described and the context provided in the question.