Hypertrophic Obstructive Cardiomyopathy with SAM

This patient presented after a syncopal episode. The ECG is abnormal with LVH and significant lateral T-wave inversions. In addition to the septal hypertrophy obstructing the left ventricular outflow tract, there is also systolic anterior motion of the mitral valve which increases obstruction and the raises the risk of tachydysrhythmia and sudden cardiac death. A patient with these findings and syncope warrant admission with cardiology consultation. Assuring adequate preload is also important.