Hypertrophic cardiomyopathy murmurs are characterized by enhancement as well as attenuation as an auxiliary criterion, and it is possible that the murmur will be attenuated if beta-blockers are used and enhanced if nitrates are used. Therefore, the disease can also be differentiated by changes in the murmur. The diagnostic criteria for hypertrophic cardiomyopathy are more varied and include history, murmur, cardiac ultrasound, and myocardial biopsy. The pathophysiology of hypertrophic cardiomyopathy is due to asymmetric thickening of the myocardium, particularly focused on the left ventricular outflow tract. If the outflow tract of the left ventricle is obstructed, some patients develop obstructive hypertrophic cardiomyopathy, and the heart murmur that is most often heard at the patient’s visit is due to the obstruction of the outflow tract. The most common heart murmurs heard on presentation are due to outflow tract obstruction, as evidenced by changes in left ventricular volume and narrowing of the outflow tract, interventricular and papillary muscle tremors, and valvular tremors. Sometimes, in addition to the heart murmur, palpation can be performed to detect tremor sounds. In addition to auscultation, palpation should be performed to identify the murmur.