A 25-year-old man with no significant medical history was playing soccer when he collapsed unexpectedly. He died despite all efforts to save his life. An autopsy is carried out. The heart weighs 580 g (normal: 350 g) on gross examination. The image depicts the cut surface of the heart. If this patient had a preparticipation sports screening, cardiac auscultation would have likely revealed a murmur that increases in intensity after which of the following?

Question

A 25-year-old man with no significant medical history was playing soccer when he collapsed unexpectedly. He died despite all efforts to save his life. An autopsy is carried out. The heart weighs 580 g (normal: 350 g) on gross examination. The image depicts the cut surface of the heart.   If this patient had a preparticipation sports screening, cardiac auscultation would have likely revealed a murmur that increases in intensity after which of the following?

Quizplus · Accepted Answer

Eductional Objective: Asymmetric ventricular septal hypertrophy and dynamic left ventricular outflow tract (LVOT) obstruction characterize hypertrophic cardiomyopathy (HCM). Decreases in LV blood volume caused by maneuvers or conditions that reduce preload (eg, abrupt standing, Valsalva strain phase) or afterload aggravate LVOT obstruction and intensify the HCM murmur.

A 25-Year-Old Man with No Significant Medical History Was Playing