A 45-year-old woman has developed increasing SOB on exertion and fatigue. She has a loud systolic ejection murmur heard best at the left sternal border, and the murmur increases with standing. A double apical impulse is also felt.For the patient with a systolic murmur, select the most likely diagnosis.
HOCM often has a bisferiens pulse. It can also be found in pure aortic regurgitation or combined aortic regurgitation and aortic stenosis.
aortic stenosis
HOCM
mitral regurgitation (chronic)
tricuspid regurgitation
C.V.S.