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    widespread 3/6 mid- to late systolic murmur and syncope

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    During a routine preparticipation examination, a 13-year-old white male admits to having had two episodes of exertional syncope. A physical examination reveals a hyperdynamic apical impulse and a widespread 3/6 mid- to late systolic murmur that seems to increase when he stands. The pulses are normal and there is no cyanosis or clubbing.

    Which one of the following statements is true regarding this patient?

    a.All strenuous exercise should be absolutely forbidden pending further evaluation
    b.This condition is frequently associated with pectus excavatum and a high, arched palate
    c.An EKG is likely to show an increased QT interval
    d.An exercise stress test under proper supervision is the test most likely to confirm the diagnosis
    e.Digoxin may be appropriate therapy to reduce the likelihood of exercise-induced symptoms

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    a.All strenuous exercise should be absolutely forbidden pending further evaluation

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    Mitral regurgitation? due to prolapse? Pectus excavatum & high arched palate?

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