A 22-year-old man comes to the clinic for a routine physical. The patient has no medical problems and takes no medication. He does not use tobacco, alcohol, or illicit drugs. He plays on his college football team and participates in intense training sessions and weekly games. Review of systems is unremarkable. Blood pressure is 120/76 mm Hg, pulse is 68/min, and respirations are 15/min. BMI is 28 kg/m. Blood pressures in the upper and lower extremities are equal. There is no jugular venous distension. Carotid upstrokes are brisk. There is a grade 2/6 early systolic murmur along the left sternal border. The murmur decreases in intensity with hand grip and passive leg elevation. Lung sounds are normal without crackles or wheezes. Echocardiogram is most likely to demonstrate which of the following findings?

Question

A 22-year-old man comes to the clinic for a routine physical. The patient has no medical problems and takes no medication. He does not use tobacco, alcohol, or illicit drugs. He plays on his college football team and participates in intense training sessions and weekly games. Review of systems is unremarkable. Blood pressure is 120/76 mm Hg, pulse is 68/min, and respirations are 15/min. BMI is 28 kg/m. Blood pressures in the upper and lower extremities are equal. There is no jugular venous distension. Carotid upstrokes are brisk. There is a grade 2/6 early systolic murmur along the left sternal border. The murmur decreases in intensity with hand grip and passive leg elevation. Lung sounds are normal without crackles or wheezes.  Echocardiogram is most likely to demonstrate which of the following findings?

Quizplus · Accepted Answer

Eductional Objective: Hypertrophic cardiomyopathy (HCM) typically involves interventricular septal hypertrophy that obstructs left ventricular (LV) outflow and creates a systolic murmur that decreases in intensity with maneuvers that increase LV blood volume (eg, hand grip, passive leg elevation). HCM is characterized by increased LV muscle mass with a small LV cavity, preserved ejection fraction, and impaired LV relaxation leading to diastolic dysfunction.

A 22-Year-Old Man Comes to the Clinic for a Routine