Figure 200s
The apex phonocardiogram is recorded simultaneously
with the
ACG and mitral valve echocardiogram. A prominent S4 is widely separated
from S1 and is coincident with the rapid upstroke of the "a"
wave on the ACG. Asymmetrical septal hypertrophy is present, and the
left ventricular cavity is small. At cardiac catheterization, no gradient
was found across the left ventricular oufflow tract.