All are true about hyperophic cardiomyopathy, except?
HOCM- AD ( b- myosin gene defect, ch-14 )- Asymmetrical septal hyperophy- L-VOTO (Left ventricular outflow tract obstruction)- characterized by predominant diastolic dysfunction. On Examination :1. Pulsus Bisfiriens (aka) "Jerky Pulse"* Fast rise initially* LVOTO contribution to sudden dip in pressure2. Apex beat- Displaced impulse- Double apical impulse (5 + 6th I/C space)3. S2: Narrow split/ single S2 / Reverse Split S2- Splitting is best Heard Best in phase of inspiration- Heard at ERB'S Point - 3rd left parasternal I/C Space.4. S4 is heard due to out flow obstruction, left atrial hyperophy occurs.5. Ejection systolic murmur* CRESENDO- DECRESENDO MURMUR* ALL Murmur | in intensity with Valsava, Standing, amyl nitrate Except - HOCM = Louder SYSTOLIC ANTERIOR MOTION(SAM) of valve seen in ECHO.
Systolic dysfunction
Dynamic left ventricular outflow tract obstruction
Diastolic dysfunction
Double apical impulse
Cardiomyopathies