Cardiology: hypertrophic cardiomyopathy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: hypertrophic cardiomyopathy

Sample item

A young athlete has exertional syncope and a harsh systolic murmur that becomes louder during Valsalva. Which diagnosis is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hypertrophic obstructive cardiomyopathy

Dynamic left-ventricular outflow obstruction in hypertrophic cardiomyopathy worsens when preload falls, so the murmur increases with Valsalva. It is an important cause of sudden death in young athletes.

Option by option

  • A. Aortic stenosis

    Fixed aortic stenosis usually decreases with reduced preload.

  • B. Hypertrophic obstructive cardiomyopathy (correct)

    Correct. Dynamic obstruction explains exertional syncope and Valsalva augmentation.

  • C. Atrial septal defect

    ASD produces a fixed split second heart sound.

  • D. Mitral regurgitation

    Mitral regurgitation is a pansystolic apical murmur radiating to the axilla.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Hypertrophic obstructive cardiomyopathy. Dynamic left-ventricular outflow obstruction in hypertrophic cardiomyopathy worsens when preload falls, so the murmur increases with Valsalva.

Why is "Aortic stenosis" not the answer?

Fixed aortic stenosis usually decreases with reduced preload.

Why is "Atrial septal defect" not the answer?

ASD produces a fixed split second heart sound.

Why is "Mitral regurgitation" not the answer?

Mitral regurgitation is a pansystolic apical murmur radiating to the axilla.

What concept does this question test?

It tests Cardiology: hypertrophic cardiomyopathy in General Medicine. It is an important cause of sudden death in young athletes.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: hypertrophic cardiomyopathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.