What clinical finding may indicate a patient is experiencing an anonymous cardiac event related to HOCM?

In hypertrophic obstructive cardiomyopathy (HOCM), a notable clinical finding is a fast heart rate accompanied by a dual upstroke pulse. This phenomenon can occur due to the dynamic outflow obstruction caused by the hypertrophied interventricular septum, which leads to turbulent blood flow and can create distinctive pulse characteristics. The rapid heart rate often arises from compensatory mechanisms in response to decreased cardiac output or increased physical demands on the heart.

The dual upstroke pulse, often termed a bisferiens pulse, suggests that there is a rapid rise and fall in the arterial pressure wave, which can be seen in conditions where there is aortic outflow obstruction or significant changes in stroke volume. These dynamics are critical in HOCM, as the condition can lead to sudden cardiac events, particularly in younger individuals or athletes.

Overall, identifying a fast heart rate along with a dual upstroke pulse helps clinicians recognize the potential for obstructive effects and associated cardiac events, aiding in the assessment and management of patients with HOCM.