Which finding, on clinical examination of the pulse, suggests a diagnosis of hypertrophic
obstructive cardiomyopathy (HOCM)?
- a. Irregularly irregular pulse
- b. Pulsus alternans
- c. Pulsus bigeminus
- d. Pulsus bisferiens
- e. Pulsus paradoxus
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Ans. The key is D. Pulsus bisferiens. [Pulsus bisferiens, is a sign where, on palpation of the pulse, a
double peak per cardiac cycle can be appreciated. Bisferious means striking twice. Classically, it is
detected when aortic insufficiency exists in association with aortic stenosis, but may also be found in
hypertrophic obstructive cardiomyopathy].