Sudden Cardiac Arrest in a 17-Year-Old Boy

In Episode 21 of Med School Question of the Week for USMLE, Leigh Finnegan answers the following: A 17-year-old boy presents to the Emergency Department after collapsing during a football game. On presentation, he is in cardiac arrest with pulseless electrical activity. Despite resuscitative measures, he is pronounced dead. An image of his heart on autopsy is shown. Which of the following physical examination findings was most likely present when he was alive?

• Systolic murmur that increases in intensity when going from supine to upright
• Opening snap followed by low diastolic rumble
• Brachiofemoral pulse delay
• Hyperdynamic pulse
• Intermittent cyanosis
• Irregularly irregular heart rhythm