Adult Echocardiography Practice Exam

Question: 1 / 400

What is the typical appearance of hypertrophic obstructive cardiomyopathy on echocardiography?

Thinning of the ventricular walls

Asymmetrical left ventricular hypertrophy and dynamic outflow obstruction

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by an abnormal thickening of the heart muscle, particularly affecting the interventricular septum and sometimes the left ventricular free wall. On echocardiography, this leads to the finding of asymmetrical left ventricular hypertrophy, meaning that the thickening is often more pronounced on one side of the heart compared to the other.

The dynamic outflow obstruction is a key feature of HOCM. This obstruction occurs during systole when the left ventricular outflow tract becomes narrowed, especially during exertion. The echocardiographic assessment can reveal this obstruction through Doppler studies, which will demonstrate an increased velocity of blood flow across the outflow tract due to the narrowing.

While increased left atrial size may be seen in some patients with HOCM as a consequence of prolonged diastolic dysfunction or elevated filling pressures, it is not the defining characteristic of the condition. Thinning of the ventricular walls and right ventricular hypertrophy do not typically align with the classic presentation of HOCM, as the hypertrophy is predominantly localized to the left ventricle. Therefore, the distinctive pattern of asymmetrical left ventricular hypertrophy with dynamic obstruction is the hallmark appearance on echoc

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Increased left atrial size

Right ventricular hypertrophy

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