The murmur of hyperophic obstructive cardiomyopathy is decreased in which of the following:: (A) Supine position, (B) Standing position, (C) Valsalva maneuver, (D) Amyl nitrate inhalation
Answer is A. Answer is A (Supine position) Condition which increase obstruction & intensity of murmur Factors that increase myocardial contractility ExerciseQ Sympathomimetic Aminese Digitalis Glycosidese Factors which decrease Ventricular volume Valsalva maneuverQ Sudden standing0 Nitroglycerines Amyl nitrites Tachycardiac Decreased aoic impedance & afterload: Conditions which decrease obstruction & intensity of murmur Factors that decrease myocardial contractility B blockers calcium channel blockers Factors which increase Ventricular volume Augmentation of venous return by passive leg raisinge Expansion of Blood Volumee Supine PositionQ Increased aoic impedance & afterload: Elevation of Aerial pressure by phenylephrinee Sustained hand gripe Squatting