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  • ECG:
    • left ventricular hypertrophy, often gross
    • ischaemic changes e.g. T wave inversion

  • chest X-ray: normal until left ventricular dilatation in heart failure

  • echocardiography is generally diagnostic, showing:
    • septal hypertrophy
    • mid-systolic closure of aortic valve
    • an anterior movement of mitral valve during systole

  • 24 hour tape - patients at risk of arrhythmias

  • exercise test carried out with care
    • blood pressure does not rise with exercise
    • possible arrythmia, peripheral circulatory collapse

  • cardiac catheterization
    • a small left ventricular cavity
    • obliteration of the cavity in systole
    • thickened trabeculae and papillary muscles

Last reviewed 01/2018