- Autosomal dominant (♂=♀) aymmmetrical septal hypertrophy
- Septal hypertrophy = obstruction but also SAM.
- SAM = Systolic Anterior Motion of the anterior leaflet of the mitral valve - the valve hits the hypertrophied septum.
- As pressure gradients ↑ (exercise) the obstruction worsens. Coronary vessels are filled during diastole ⇒ ischaemia ±arrhythmia.
Chest pain, palpitations or pre-syncope during excecise.
Ask about FHx of HOCM or sudden cardiac death.
- S4 or split second heart sound
- Crescendo-decrescendo systolic murmur (↑ with valsalva)
- Mitral regurg. murmur
- Resp. exam. normal