A 18-year-old man notices occasional lightheadedness when standing up quickly. He also has difficulty playing sports because of easy fatigue and SOB. Examination shows normal heart sounds, but a loud systolic ejection murmur at the right sternal border. The murmur decreases with elevating the legs and increases in the standing position. Your clinical diagnosis is hypertrophic cardiomyopathy (HOCM).For the above patients, select the characteristic arterial pulse finding.
High-Yield Explanation
The bisferiens pulse, two systolic peaks, occurs in HOCM and aortic regurgitation. In aortic regurgitation, the bisferiens pulse can occur both in the presence or absence of aortic stenosis.