5th May 2025

Miss Okoye is a 27-year-old university student who presents to the general cardiology clinic following referral by her GP.

Miss Okoye is a 27-year-old university student who presents to the general cardiology clinic following referral by her GP. She attended her GP due to periods of frequent blackouts when going jogging. She describes periods of ‘blackouts’ whilst exercising when she suddenly feels short of breath and loses consciousness. She wakes up knowing exactly where she is and what happened prior to losing consciousness. The GP noted some changes on her 12-lead resting ECG (shown below) and referred her to the Cardiologist. The GP did some blood tests which showed evidence of a microcytic anaemia but normal coagulation, electrolyte and liver biochemistry. Miss Okoye is an avid exercise enthusiast and states the recurrent syncopal episodes are significantly affecting her quality of life. You notice normal vital signs with a resting heart rate of 65 beats per minute with normal lying-standing blood pressure. You cannot hear any murmurs on cardiac auscultation. Given the findings and the likely cause of her symptoms, what is the most likely long-term management for Miss Okoye?

Select the SINGLE most appropriate option from the list below. Select ONE option only.