What is a characteristic physical finding in a patient with hypertrophic cardiomyopathy?

A characteristic physical finding in a patient with hypertrophic cardiomyopathy is the presence of a systolic murmur. This murmur results primarily from the left ventricular outflow tract obstruction that occurs due to the hypertrophied myocardium. As the ventricle contracts during systole, the thickened muscle can impede the flow of blood out of the heart, leading to turbulent blood flow, which is perceived as a systolic murmur, often best heard at the left sternal border.

The murmur may vary with positioning, such as increasing when the patient stands or performs the Valsalva maneuver, due to changes in preload. This unique feature helps differentiate it from other cardiac conditions. The clinical significance of identifying this murmur lies in its association with the increased risk of arrhythmias and sudden cardiac death in affected individuals.

In contrast, diastolic murmurs are typically related to different pathologies, such as aortic or mitral stenosis, and bradycardia, an abnormally slow heart rate, is not a common finding associated with hypertrophic cardiomyopathy. Similarly, an absence of heart sounds would indicate a more severe and acute situation, such as cardiac tamponade or severe heart failure, rather than hypertrophic