62. A 32-year-old man is seen for an annual physical examination. There is no personal or family history of cardiovascular disease or symptoms. On physical examination, S1 and S2 are normal and there is an S4 present. There is a grade 2/6 crescendo-decrescendo systolic murmur heard best at the lower left sternal border. The murmur does not radiate to the carotid arteries. Valsalva maneuver increases the intensity of the murmur, and moving from a standing position to a squatting position, performing a passive leg lift while recumbent, and performing isometric handgrip exercises decreases the intensity. Rapid upstrokes of the peripheral pulses are present. A Mitral valve prolapse B Hypertrophic cardiomyopathy C Atrial septal defect D Ventricular septal defect E Aortic stenosis
63. A 32-year-old man is seen for an annual physical examination. There is no personal or family history of cardiovascular disease or symptoms. On physical examination, S1 and S2 are normal and there is an S4 present. There is a grade 2/6 crescendo-decrescendo systolic murmur heard best at the lower left sternal border. The murmur does not radiate to the carotid arteries. Valsalva maneuver increases the intensity of the murmur, and moving from a standing position to a squatting position, performing a passive leg lift while recumbent, and performing isometric handgrip exercises decreases the intensity. Rapid upstrokes of the peripheral pulses are present. A Mitral valve prolapse B Hypertrophic cardiomyopathy C Atrial septal defect D Ventricular septal defect E Aortic stenosis
64. A 23-year-old man is evaluated for palpitations that occur during exercise. He is otherwise healthy and takes no medications. Both the physical examination and the resting electrocardiogram are normal. A stress test demonstrates sustained monomorphic ventricular tachycardia at 201/min at peak exercise. There were no ischemic changes until the arrhythmia developed. The ventricular tachycardia had a left bundle and inferior axis morphology and terminated spontaneously after 7 minutes of rest. An echocardiogram is normal, and an MRI shows no abnormalities in the right or left ventricles. What is the most likely etiology of ventricular tachycardia in this patient? A Coronary spasm B Idiopathic C Arrhythmogenic right ventricular cardiomyopathy D Infiltrative heart disease E Anomalous origin of the coronary arteries
65. A 23-year-old man is evaluated for palpitations that occur during exercise. He is otherwise healthy and takes no medications. Both the physical examination and the resting electrocardiogram are normal. A stress test demonstrates sustained monomorphic ventricular tachycardia at 201/min at peak exercise. There were no ischemic changes until the arrhythmia developed. The ventricular tachycardia had a left bundle and inferior axis morphology and terminated spontaneously after 7 minutes of rest. An echocardiogram is normal, and an MRI shows no abnormalities in the right or left ventricles. What is the most likely etiology of ventricular tachycardia in this patient? A Coronary spasm B Idiopathic C Arrhythmogenic right ventricular cardiomyopathy D Infiltrative heart disease E Anomalous origin of the coronary arteries
66. A: ARVD B: Goldwire’s space re-entry vehicle C: Spaceballs hat hair
67. A: ARVD B: Goldwire’s space re-entry vehicle C: Spaceballs hat hair
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