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Dynamic left ventricular outflow tract (LVOT) obstruction and mitral leaflet systolic anterior motion (SAM) are complex haemodynamic features of hypertrophic cardiomyopathy (HCM). Dynamic auscultation remains a mandatory step in clinical assessment; augmentation of the crescendo-decrescendo systolic murmur with reduced preload (Valsalva maneuver, amyl nitrite, and squat-to-stand) and diminution with increased afterload (handgrip and …

Dynamic auscultation in hypertrophic obstructive cardiomyopathy: what can we learn from a murmur?