Review Question - QID 213452

A 15-year-old boy presents to his physician for a routine sports physical to participate in tryouts for his high school track team. On physical examination, the physician identifies an S4 gallop as well as a systolic ejection crescendo-decrescendo murmur that increases when the patient is asked to attempt forced exhalation with his mouth closed. The patient is referred to a cardiologist, and an electrocardiogram (ECG) is obtained (Figure A). Which of the following echocardiogram findings would most likely correspond with this patient’s physical examination and ECG findings?