Fast Five Quiz: Hypertrophic Cardiomyopathy

Jamshid Shirani, MD


April 13, 2022

Electrocardiogram abnormalities are present in most patients diagnosed with HCM and may be the only manifestation of early disease. Common abnormalities include ST-T wave abnormalities, LVH by voltage, abnormal QRS axis, and conduction abnormalities.

Auscultation in HCM patients is characterized by the presence of S4 gallop and a systolic ejection murmur; the harsh crescendo-decrescendo murmur is best heard between the left sternal border and the apex. The murmur increases in intensity with Valsalva maneuver and standing, which decrease preload, and decreases in intensity with squatting and Müller's maneuver, which increase preload.

The diagnosis of HCM is confirmed by the presence of a left ventricular wall thickness of at least 15 mm on echocardiogram.

Learn more about HCM.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.