Hypertrophic Cardiomyopathy

This Daily Doodle is an abstract illustration of Hypertrophic Cardiomyopathy (HCM), a disease of the myocardium (heart muscle). The hallmark of this condition is asymmetrical myocardial hypertrophy (thickening), typically of the left ventricle and often the interventricular septum. This thickening of the heart wall can lead to obstruction of outflow (as shown in the doodle), diastolic dysfunction, myocardial ischemia, mitral regurgitation and even, sudden death. In fact, HCM is a leading cause of sudden cardiac death in young athletes.

This Daily Doodle highlights two of the murmurs that may be present on physical examination:

  1. Systolic crescendo-decrescendo murmur at the left sternal border which increases with the valsalva maneuver and standing. This murmur is different than aortic stenosis which typically decreases in intensity with the valsalva maneuver.
  2. Holosytolic murmur of mitral regurgitation at the apex

The characteristic of each murmur is shown through orange and red ribbons. The first ribbon is tightly curled and then expands and tightens again, representing the crescendo-decrescendo murmur. The second holosystolic murmur is represented by continuously flowing ribbons over the mitral valve.



  1. M. Maron and P. Elliott. “Clinical manifestations, diagnosis and evaluation of hypertrophic cardiomyopathy” Uptodate.com.



“Hypertrophic Cardiomyopathy” Daily Doodle by Michiko Maruyama

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