American Board of Internal Medicine (ABIM) Certification Practice Exam

Which factor is NOT typically considered a major risk factor for sudden cardiac death in hypertrophic cardiomyopathy?

1. Prior cardiac arrest

2. Family history of sudden death

3. Age over 60

4. Ventricular tachycardia

The correct answer is: Age over 60

In the context of hypertrophic cardiomyopathy (HCM), the factors commonly identified as major risk factors for sudden cardiac death include prior cardiac arrest, a family history of sudden death, and the presence of ventricular tachycardia. These factors are associated with a higher likelihood of arrhythmias and adverse outcomes due to the structural and electrical abnormalities caused by HCM. Prior cardiac arrest signifies that an individual has already experienced a life-threatening arrhythmic event, thus increasing the risk for future episodes. A family history of sudden death can suggest a genetic predisposition to arrhythmias, and ventricular tachycardia indicates the presence of dangerous rhythms that can precipitate sudden cardiac arrest. On the other hand, age over 60 is not typically recognized as a major risk factor for sudden cardiac death in HCM. While age can contribute to overall cardiovascular risk, HCM-related sudden cardiac death is more closely associated with the specific risk factors mentioned. In fact, younger patients with HCM are often considered at higher risk, especially if they exhibit any of the other key indicators like previous cardiac arrest or significant ventricular arrhythmias.