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.
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Cite this: Jamshid Shirani. Fast Five Quiz: Hypertrophic Cardiomyopathy - Medscape - Apr 13, 2022.