Mitral regurgitation in hypertrophic cardiomyopathy is most often eccentric, as the primary mechanism is related to the faulty angle of attachment between the papillary muscles and mitral valve leaflets. If systolic anterior motion of the mitral valve is the cause, the jet of regurgitation will be directed posteriorly. The murmur of mitral regurgitation in hypertrophic cardiomyopathy is rarely pansystolic, as the mechanism of regurgitation begins after systole has started. It can be difficult to differentiate the murmur of mitral regurgitation from that of left ventricular outflow tract obstruction.

1. Mitral Regurgitation

10. WHAT ARE THE MECHANISMS OF MITRAL REGURGITATION IN
HOCM ?
AUGUST 12, 2011 BY DR S VENKATESAN
ECCENTRIC MR VS CENTRAL MR
In HOCM the MR is more often eccentric .This is understandable as the
primary mechanism is related to faulty angle of pap. muscle vs leaflet
attachment.
If SAM is primary mechanism jet is directed posterior.
MURMUR OF MR IN HOCM
Is rarely pansytolic as the mechanism of MR begins to operate well after the
systole starts .
Many times it is difficult to differentiate LVOT murmur from MR murmur .
The ever confusing and tentative maneuvers might help the few shrewd
cardiologists.

12. ATYPICAL ‘Q’ WAVES: INF-LAT LEADS