Which heart sound is commonly associated with hypertrophic cardiomyopathy?

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Multiple Choice

Which heart sound is commonly associated with hypertrophic cardiomyopathy?

Explanation:
A late diastolic sound (the fourth heart sound) is produced when the atria contract against a stiff, noncompliant ventricle. In hypertrophic cardiomyopathy the left ventricle is thickened and less compliant, so atrial contraction against this stiff ventricle creates an audible S4. This gallop is best heard at the apex with the patient in the left lateral position and is a hallmark of diastolic dysfunction due to LV hypertrophy. By contrast, S3 reflects rapid filling into a dilated or volume-overloaded ventricle, S1 marks the start of systole from valve closure, and having no abnormal sound would miss a common diastolic gallop seen in HCM.

A late diastolic sound (the fourth heart sound) is produced when the atria contract against a stiff, noncompliant ventricle. In hypertrophic cardiomyopathy the left ventricle is thickened and less compliant, so atrial contraction against this stiff ventricle creates an audible S4. This gallop is best heard at the apex with the patient in the left lateral position and is a hallmark of diastolic dysfunction due to LV hypertrophy. By contrast, S3 reflects rapid filling into a dilated or volume-overloaded ventricle, S1 marks the start of systole from valve closure, and having no abnormal sound would miss a common diastolic gallop seen in HCM.

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