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Author8 Posts
  #1

Which of the following is true about the murmur of hypertrophic cardiomyopathy?
A Decrease by Valsalva
B Decrease by handgrip
C Decrease by standing after squatting
D Increase by phenylephrine
E Increase by leg elevation

  #2

B Decrease by handgrip

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  #3

What about A?

  #4

murmur of hypertrophic cardiomyopathy is increased by Valsalva and standing, decreased by isometric exercise and squatting

  #5

In general, Anything that causes an Increase in Afterload and/or incr in Preload
decreases the Murmur of HCOM.

So what does Isometric Exercise do n how?



  #6

But according to eMedicine, the murmur has following characteristics:

The murmur and the gradient across the LV outflow tract diminish with any increase in preload (eg, Valsalva maneuver, Müller maneuver, squatting) or increase in afterload (eg, handgrip). The murmur and the gradient increase with any decrease in preload (eg, that elicited by nitrate medications, diuretics, standing) or with any decrease in afterload (eg, that elicited by vasodilators).

  #7

I believe Valsalva increase preload, therefore decrease the murmur

doyoudig wrote:
In general, Anything that causes an Increase in Afterload and/or incr in Preload
decreases the Murmur of HCOM.

So what does Isometric Exercise do n how?




  #8

fongch
Valsalva causes a decrease in preload so it will increase the murmur of hypertrophic cardiomyopathy... therefore A is wrong
remember valsalva increases intrathoracic pressure --> decreasing venous return --> decreasing preload

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