The patient is a 20-year-old man who presents to a medical clinic for a routine physical required before he enlists in the army. his family history is significant for 2 relatives who had sudden cardiac arrest in their late 20's or early 30's. he does not know any more details about these relatives or their medical history. his review of systems is negative with the exception of rare episodes of heart palpitations. what is the most likely finding on the patient's cardiac examination if he has hypertrophic cardiomyopathy? a soft heart sounds and an s3 gallopb brisk heart sounds and an s4 gallopc early diastolic pericardial knockd s4 gallop and no murmure 3 component friction rub

the most likely finding on the patient´s cardiac examination if he has hypertrophic cardiomyopathy is B. brisk heart sounds and s4 gallop

Explanation:

The hypertrophic Left Ventricle (VI) is very distensible and its relaxation may take longer or be incomplete. To maintain cardiac output (GC) it is necessary to increase the sympathetic system: stronger heart contractions and increased heart rate, but all these compensatory mechanisms only work as temporary adaptation, if they are maintained over time they will otherwise generate harmful effects .

To achieve the filling of the Left Ventricle, higher than normal venous pressures are necessary, which leads to the atrial dilate and this situation predisposes the patient to pulmonary venous hypertension or edema.

In addition, a displacement of the mitral valve against the hypertrophic septum is generated, at the beginning of the systole the speed of blood passage through the stenosis is increased in the left ventricular outflow tract creating turbulence which results in a blew it. Finally, an increase in the left intraventricular pressure is generated, which generates an increase in myocardial wall stress and oxygen demand.

ok will do i shall do that now

probably since the potency of the cocaine, not a lot, but i've never done any research on cocaine so i wouldn't know, but i would also guess it would determine on the gap between sniffs or if you did it all at once, so i really don't know.