Which finding is not typical in an examination for hypertrophic cardiomyopathy?

In the examination for hypertrophic cardiomyopathy, a split S2 is typically not a finding associated with the condition. In fact, patients with hypertrophic cardiomyopathy often have a sustained and forceful contraction of the heart muscle, which can lead to a decrease in the physiological splitting of the second heart sound during systole. This is because the left ventricle may be functioning more vigorously than the right, leading to an overall impact on heart sound patterns.

On the other hand, a systolic murmur at the right sternal border that increases with Valsalva is common in hypertrophic cardiomyopathy due to the obstruction of blood flow caused by the hypertrophied muscle. A prolonged QT interval on an EKG can also occur as a consequence of certain arrhythmias associated with the condition. Lastly, systolic blood pressure readings greater than 140 on two or more occasions may indicate hypertension, which can coexist with hypertrophic cardiomyopathy but is not a defining attribute of the disease itself. Thus, split S2 stands out as a finding not typically associated with hypertrophic cardiomyopathy.