Features of hypertonic cardiomyopathy include all of the following except:

Features of hypertonic cardiomyopathy include all of the following except:

• A. Harsh systolic ejection murmur
• B. The presence of mitochondrial anomalies
• C. Atrial fibrillation
• D. Mural thrombus formation and emboli action

Answer: (B)

Hypertrophic cardiomyopathy presents with signs and complications tied to a thickened, stiff left ventricle and dynamic LV outflow tract obstruction. The harsh systolic murmur comes from the obstructed outflow tract and changes with preload and afterload, often becoming louder with reduced preload (like standing or Valsalva). Atrial fibrillation is common because the stiff ventricle leads to left atrial enlargement and electrical irritability. Mural thrombus formation and emboli can occur, particularly with apical hypertrophy where flow is more stagnant or when an apical aneurysm develops. Mitochondrial anomalies are not typical features of hypertrophic cardiomyopathy; the disease more commonly arises from mutations in sarcomeric proteins causing myocyte disarray and fibrosis rather than primary mitochondrial defects.

Hypertrophic cardiomyopathy presents with signs and complications tied to a thickened, stiff left ventricle and dynamic LV outflow tract obstruction. The harsh systolic murmur comes from the obstructed outflow tract and changes with preload and afterload, often becoming louder with reduced preload (like standing or Valsalva). Atrial fibrillation is common because the stiff ventricle leads to left atrial enlargement and electrical irritability. Mural thrombus formation and emboli can occur, particularly with apical hypertrophy where flow is more stagnant or when an apical aneurysm develops. Mitochondrial anomalies are not typical features of hypertrophic cardiomyopathy; the disease more commonly arises from mutations in sarcomeric proteins causing myocyte disarray and fibrosis rather than primary mitochondrial defects.