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Forensic Medicine · Thanatology: sudden cardiac death in a young athlete
Sample itemA 19-year-old athlete collapses and dies during training. Autopsy shows a heavy heart with asymmetric thickening of the septum, and microscopy shows haphazardly arranged, disorganised myocytes. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a leading cause of sudden death in young athletes and shows asymmetric septal thickening with myocyte disarray and fibrosis. Arrhythmogenic right ventricular cardiomyopathy shows fatty and fibrous replacement of the right ventricle, while myocarditis shows an inflammatory infiltrate.
Option by option
A. Arrhythmogenic right ventricular cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy shows fibrofatty replacement of the right ventricular wall.
B. Hypertrophic cardiomyopathy (correct)
Correct. Septal thickening with myocyte disarray is characteristic.
C. Acute myocarditis
Myocarditis shows inflammatory cells and myocyte necrosis, not disarray.
D. Dilated cardiomyopathy
Dilated cardiomyopathy gives dilated chambers with thin or normal walls.
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.
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