Hypertrophic Cardiomyopathy

Description

Hypertrophic cardiomyopathy (HCM) is a congenital or acquired disorder characterized by marked ventricular hypertrophy with diastolic dysfunction but without increased afterload (e.g, from valvular aortic stenosis, coarctation of the aorta, systemic hypertension). Symptoms include dyspnea, chest pain, syncope, and sudden death. A systolic murmur, increased by Valsalva maneuver, is typically present in the hypertrophic obstructive type.

Now you can listen to an example of typical for this pathology hearts sound. You can hear the difference between the two murmurs by moving the stethoscope head the aortic to the mitral valve area. First, you will hear the diamond shaped aortic murmur and later the rectangular pan-systolic murmur. 

An early peaking, harsh diamond shaped systolic murmur starts at the beginning of systole and ends well before the second heart sound. A fourth heart sound gallop is also present in diastole .S1 is increased due to a hyperdynamic of left ventricle. S2 is single. The strong contraction of the left ventricle causes the anterior leaflet to be sucked into the ventricle, blocking the flow into the aorta and causing an aortic murmur. At the same time turbulent flow from the left ventricle to the left atrium causes a second murmur. Since the two murmurs occur at the same time you hear a single murmur. 
Hypertrophic Cardiomyopathy

Maneuver: Supine
Position: Mitral
Chestpiece: Diaphragm

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