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This may be caused by systolic anterior motion of the mitral valve (SAM) and mid-systolic contact of the left ventricular free wall (LVFW) with the interventricular septum (IVS) during systole.  
 
This may be caused by systolic anterior motion of the mitral valve (SAM) and mid-systolic contact of the left ventricular free wall (LVFW) with the interventricular septum (IVS) during systole.  
 
====Systolic Anterior Motion of the Mitral Valve (SAM)====
 
====Systolic Anterior Motion of the Mitral Valve (SAM)====
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This is where the anterior mitral valve leaflet moves towards the IVS in systole, therefore creating obstruction in the left ventricular outflow tract which interferes with the LV outflow in mid-systole.  As a result of this movement, the mitral valve leaflet does not completely seal the atrioventricular annulus; this causes a secondary mitral regurgitation. The combination of turbulent blood flow in the left ventricular outflow tract and mitral regurgitation causes a systolic murmur which can be identified on auscultation.
    
==Clinical Signs==
 
==Clinical Signs==
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