Mr MH, a 24 year old man presents to the

cardiology out patient department complaining of

dyspnoea. He gives a history of episodes
simulating angina pectoris in past and also
complains of fatigue and syncopal attacks. On
examination there was a triple apical pre cordial
impluse, rapidly rising carotid arteral pulse and
a fourth heart sound. Hypertrophic cardiomyopathy
was confirmed by chocardiogram. !hich of the
following is true "#
Options
A. $ymmetrical hypertrophy of left ventricle and
interventricular septum occurs.
B. %here is a systolic dysfunction.
C. %he murmur of this condition decreases in the
valsalva Manuveur
D. &itroglycerine is contraindicated in these
patients.
E. %he condition is associated with mutation in
cardiac#beta#myosin heavy chain gene on
chromosome '(.
)n hypertrophic cardiomyopathy, there is asymmetrical
hypertrophy, preferrential hypertrophy of )nterventricular
septum, there is diastolic dysfunction rather than systolic,
Murmur increases in valsalva Maneuvoure and on sudden standing.
)t is also increased by exercise and administration of
sympathomimetic amines and digitalis, Murmur decreases in supine
position and sustained hand grip. *igitalis, diuretics, &itrates,
&itroglycerine, +asodialators and ,eta adrenergic agonists are
avoided. 4-. of patients carry mutations of cardiac beta Myosin
heavy chain on chromosome 14 .