Physical exam of hypertrophic cardiomyopathy
- Sustained PMI, S2 paradoxically split if severe outflow obstruction, ⊕ S4 (occ. palpable)
- Systolic murmur: crescendo-decrescendo; LLSB; ↑ w/ Valsalva & standing (↓ preload)
- ± mid-to-late or holosystolic murmur of MR at apex
- Bifid (biphasic) carotid pulse (brisk rise, decline, then 2nd rise); JVP w/ prominent a wave
- Contrast to AS, which has murmur that ↓ w/ Valsalva and ↓ carotid pulses