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  #1  
Old 08-02-2011
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Question HCM Vs MVP

Dear everyone

I would like to know the effect of increasing afterload on murmurs of hypertrophic cardiomyopathy and Mitral valve prolapse.

Correct me if I am wrong in the following:

Increasing preload decreases their murmurs because in case of HCM: increased preload leads to icrease LV volume and thus reduced obstruction. while in MVP increased preload leads to increased tension on chordea tendinae and thus longer valve closure.
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  #2  
Old 08-02-2011
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Quote:
Originally Posted by drzamzam View Post
Dear everyone

I would like to know the effect of increasing afterload on murmurs of hypertrophic cardiomyopathy and Mitral valve prolapse.

Correct me if I am wrong in the following:

Increasing preload decreases their murmurs because in case of HCM: increased preload leads to icrease LV volume and thus reduced obstruction. while in MVP increased preload leads to increased tension on chordea tendinae and thus longer valve closure.
Effect of Valsalva
The Valsalva maneuver works by decreasing preload to the heart



it causes decrease of intensity of murmurs of


Aortic Stenosis

Pulmonic Stenosis

Tricuspid Regurgitation

Increased intensity of murmurs of


Hypertrophic cardiomyopathy, mitral valve prolapse
for example in HOCM it causes decrease in VR so less dilation of left ventricle less relief of obstruction increased intensity of murmur on the same concept all other conditions are explained

Hand GRIP:The handgrip maneuever is performed by clenching one's fist forcefully for a sustained time until fatiguedThe handgrip maneuver increases afterload by squeezing the arterioles and increasing Total Peripheral Resistance.no effect on venous return unlike squatting

Increased intensity of murmurs of
Aortic Regurgitation, Mitral Regurgitation ,Ventricular Septal Defect
decrease intensity of murmurs of

Aortic Stenosis , Mitral Stenosis , Hypertrophic Cardiomyopathy
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  #3  
Old 08-03-2011
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Quote:
Originally Posted by usmleman2020 View Post
[/B]Increased intensity of murmurs of
Aortic Regurgitation, Mitral Regurgitation ,Ventricular Septal Defect
decrease intensity of murmurs of

Aortic Stenosis , Mitral Stenosis , Hypertrophic Cardiomyopathy
Excellent explanation, but I have few more questions if you don't mind
1) increasing afterload decreases murmur intensity of HOCM, but what about mitral valve proplapse ???
2) Does squatting increase both afterload and preload ? or only 1 of them ? and if so what is the mechanism ?
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