Question

question 40 (mandatory) (2 points) listen a 20 year old patient presents with sudden death on exertion. on examination of the heart it is found to be enlarged, but with asymmetric enlargement of the interventricular septum and on microscopy the fibers are found to have a \woven bone\ pattern and disorganized. what is the most likely diagnosis in this patient? coxsackie virus myocarditis obliterative cardiomyopathy restrictive cardiomyopathy hypertrophic cardiomyopathy

Explanation:

Hypertrophic cardiomyopathy (HCM) is characterized by asymmetric ventricular hypertrophy (often involving the interventricular septum). Microscopically, there is myocyte disarray (described as a "woven bone" - like pattern). Sudden death on exertion is a well - known complication of HCM, especially in young individuals.
Coxsackie virus myocarditis would show inflammatory cell infiltrates (e.g., lymphocytes) in the myocardium. Obliterative cardiomyopathy (also known as endomyocardial fibrosis) is associated with fibrotic obliteration of the ventricular apices. Restrictive cardiomyopathy is characterized by reduced ventricular compliance due to non - hypertrophied, non - dilated ventricles (e.g., due to amyloidosis deposition in some cases), and not by the myocyte disarray and asymmetric septal hypertrophy seen here.

Answer:

Hypertrophic cardiomyopathy