Question

The only systolic murmur which INCREASES in intensity during the STRAIN phase ("bear down") of a Valsalva maneuver is one associated with which one of the following conditions?

Mitral valve prolapse

Hypertrophic cardiomyopathy

aortic stenosis

Pulmonary edema

Answer 1

In the above question the condition which is associated with strain phase of valsalva maneuver in which systolic murmur is increased is HYPERTROPHIC CARDIOMYOPATHY.pre load means the amount of blood returns to the heart here pre load of heart is decrrased with valsalva.during bearing down phase because of straining left ventricular airflow obstruction can hsppen which is responsible for increasing the intensity of systolic murmur.