Hypertrophic Cardiomyopathy

The recording was made with the patient supine. The stethoscope is positioned in the 3rd - 4th intercostal space along the left parasternal border i.e just to the left of the sternum using the diaphragm mode. The stethoscope is over the left ventricular outflow tract, below the level of the aortic valve.

The obstruction is "dynamic", i.e the obstruction becomes progressively more severe as the ventricle contracts. The murmur therefore increases in intensity during systole as the obstruction increases.

The murmur may be confused with that of aortic stenosis. Note however that the aortic component of the second heart sound is easily audible, whereas in aortic stenosis the second heart sound is usually soft.
 

Contributed by Dr. Darryl A Smith FCP (SA) Cardiology