Abstract
Hypertrophic Cardiomyopathy (HCM) is a disorder which causes hypertrophy of the interventricular septum of the heart, leading to obstruction of left ventricular outflow during systole. The murmur that is pathognomonic for HCM is a crescendo-decrescendo holosystolic murmur best heard at the left sternal boarder. The murmur classically increases with standing and valsalva, while it decreases with squatting, hand-grip, and passive leg lift. Symptoms, if present, are usually found on exertion and include chest pain, dizziness/lightheadedness, and syncope; because there are often no symptoms, HCM is one of the most common causes of sudden death in young athletes. Treatment is aimed at minimizing the obstruction by increasing the diastolic filling of the left ventricle through abstinence from high-intensity cardiovascular activity, and use of beta-blockers, calcium channel blockers, disopyramide, and/or surgery.
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1 Electronic Supplementary Material
Video 8.1
Murmur of a patient with HC, including the effect of squatting, as described by Dr. W. Proctor Harvey (File 359 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved.) (MP4 11140 kb)
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Shechtel, J.L. (2015). Hypertrophic Obstructive Cardiomyopathy. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_8
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DOI: https://doi.org/10.1007/978-1-4471-6738-9_8
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