A teenager with a history of cardiomyopathy and recurrent syncope was admitted to the pediatric unit with a urinary tract infection. Levofloxacin was started along with outpatient medications of metoprolol and valsartan. The patient had symptomatic improvement of the urinary tract infection and was ready for discharge on day 3 after hospital admission. However, the patient lost consciousness suddenly and had seizurelike activities with urine incontinence. The patient regained consciousness with a blood pressure of 86/45 mm Hg and pulse oximetry of 95% on oxygen via nasal cannula after brief cardiopulmonary resuscitation. A 12-lead electrocardiogram (ECG) was urgently obtained and is shown in the Figure. A bedside 2-dimensional echocardiography revealed biatrial enlargement, left ventricular hypertrophy with ejection fraction of 47%, and no pericardial effusion.
Please finish quiz first before checking answer.
Read the answer below and download your certificate.
Read the discussion below and retake the quiz.
Sign in to take quiz and track your certificates
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Authors: Kui Hong, MD, PhD, Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China (email@example.com); Gan-Xin Yan, MD, PhD, Lankenau Medical Center, Main Line Health, 100 E Lancaster Ave, Wynnewood, PA 19096 (firstname.lastname@example.org).
Published Online: February 27, 2023. doi:10.1001/jamainternmed.2022.6455
Conflict of Interest Disclosures: Prof Yan reported grants from the Sharpe-Strumia Research Foundation outside the submitted work. No other disclosures were reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
You currently have no searches saved.
You currently have no courses saved.