John, a 40-year-old male, was born with an incompetent mitral valve that permits some blood backflow. Recently Josh began to have worsening symptoms especially breathlessness upon exercise and went to see his cardiologist. The doctor determined that the thickness of the myocardium of the left ventricle has significantly increased.
1. Was the increase in thickness caused by his genetic defect? Why? (think preload & afterload)
2. Does Josh have the typical heart sounds "lub dub"?