An 18-year-old boy is brought to the hospital with loss of consciousness. He regains consciousness in the ER, and GCS on admission is 12/15. CNS examination is normal and auscultation reveals a narrow split S2 and clear lungs. ECG was done. Diagnosis is?

The ECG shows a hea rate of 60/min with left axis detion SV1+RV5> 35 mm is suggestive of left ventricular hyperophy SV1 = 20mm and RV5= 30mm Narrow split S2 indicates outflow tract obstruction Taking into consideration the age, the patient either suffers from HOCM or valvular aoic stenosis. The low cardiac output can lead to exeional syncope.