Which physical examination finding is commonly associated with dilated cardiomyopathy?

Which physical examination finding is commonly associated with dilated cardiomyopathy?

• A. S4 gallop
• B. No murmurs
• C. S3 gallop
• D. Murmur of aortic stenosis

Answer: (C)

In dilated cardiomyopathy, the ventricle becomes dilated and systolic function declines, leading to volume overload and higher filling pressures. This often produces a soft, low-pitched S3 gallop, heard best with the patient in the left lateral decubitus position at the apex in early diastole after S2. The S3 reflects rapid, passive filling of a dilated ventricle and indicates increased left ventricular end-diastolic volume and poor systolic function; it is a common finding in congestive heart failure due to dilated ventricles. S4 gallops, by contrast, arise from a stiff, noncompliant ventricle and are more typical of long-standing hypertension or hypertrophic or restrictive conditions, not the dilated, failing ventricle seen in this cardiomyopathy. Murmurs can be present if valves are involved (for example, functional mitral regurgitation from annular dilation), but they are not the hallmark sign. Aortic stenosis murmur is not characteristic of dilated cardiomyopathy.

In dilated cardiomyopathy, the ventricle becomes dilated and systolic function declines, leading to volume overload and higher filling pressures. This often produces a soft, low-pitched S3 gallop, heard best with the patient in the left lateral decubitus position at the apex in early diastole after S2. The S3 reflects rapid, passive filling of a dilated ventricle and indicates increased left ventricular end-diastolic volume and poor systolic function; it is a common finding in congestive heart failure due to dilated ventricles.

S4 gallops, by contrast, arise from a stiff, noncompliant ventricle and are more typical of long-standing hypertension or hypertrophic or restrictive conditions, not the dilated, failing ventricle seen in this cardiomyopathy. Murmurs can be present if valves are involved (for example, functional mitral regurgitation from annular dilation), but they are not the hallmark sign. Aortic stenosis murmur is not characteristic of dilated cardiomyopathy.