{"id":3107,"date":"2020-05-27T11:19:16","date_gmt":"2020-05-27T18:19:16","guid":{"rendered":"https:\/\/up.physicaldiagnosispdx.com\/up\/?page_id=3107"},"modified":"2020-10-15T22:24:40","modified_gmt":"2020-10-16T05:24:40","slug":"3107-2","status":"publish","type":"page","link":"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-multimedia-new\/3107-2\/","title":{"rendered":"Hypertrophic Obstructive Cardiomyopathy (HOCM)"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row css=&#8221;.vc_custom_1592006059810{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text]<span style=\"font-size: 14pt;\">The HOCM murmur is louder when the ventricular volume is low, as the outflow tract is narrower, so you can make this murmur louder by having the patient Valsalva or go from squatting to standing.&nbsp;The murmur will become softer by increasing preload, such as with squatting or passive leg raise.<\/span><br \/>\n<figure id=\"attachment_1658\" aria-describedby=\"caption-attachment-1658\" style=\"width: 150px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/card-tutorial\/#Hypertrophic_Obstructive_Cardiomyopathy_HOCM\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-1658 size-thumbnail\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png 150w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-300x300.png 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308.png 512w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><figcaption id=\"caption-attachment-1658\" class=\"wp-caption-text\">&nbsp;<\/figcaption><\/figure>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 1:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a middle-aged woman who was admitted to the hospital with a known diagnosis of hypertrophic obstructive cardiomyopathy. Echocardiography demonstrated severe left ventricular outflow tract obstruction with a gradient of 183 mm Hg. It also showed severe mitral valve regurgitation related to systolic anterior motion of the mitral valve. Note that the murmur increases in intensity with Valsalva.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592006081923{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Hypertrophic Obstructive Cardiomyopathy<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463367286?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&gt;\ufeff&lt;\/span&gt;<\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463376699?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 2:<\/h1>\n<p><span style=\"font-size: 14pt;\">This patient has hypertrophic obstructive cardiomyopathy. Note that the intensity of the murmur increases after the patient goes from a squatting position to a standing position.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592006097465{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Hypertrophic Obstructive Cardiomyopathy<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463361921?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/468821691?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css=&#8221;.vc_custom_1592006059810{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text]The HOCM murmur is louder when the ventricular volume is low, as the outflow tract is narrower, so you can make this murmur louder by having the patient Valsalva or go from squatting to standing.&nbsp;The murmur will become softer by increasing preload, such as with squatting or<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":3164,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"page-templates\/page_PDXPDX-full-width.php","meta":{"nf_dc_page":"","_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-3107","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3107","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/comments?post=3107"}],"version-history":[{"count":0,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3107\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3164"}],"wp:attachment":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/media?parent=3107"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}