Characteristics of murmur in hypertrophic obstructive cardiomyopathy

Hypertrophic obstructive cardiomyopathy murmurs are characterized by ejection mid-late systolic murmurs.

Hypertrophic obstructive cardiomyopathy may detect coarse ejection mid-late systolic murs on auscultation between the third and fourth ribs at the left sternal margin, accompanied by tremors. Systolic murs may also be heard at the apex due to mitral insufficiency as the anterior mitral leaflet moves toward the interventricular septum

. Murmurs may be intensified by increasing myocardial contractility or reducing cardiac afterload, and may be heard louder, attenuated by decreasing myocardial contractility or increasing cardiac afterload, and attenuated in squatting position.