Images in Clinical Medicine

Kim Eagle, M.D., Editor

Pressure Tracings in Obstructive Cardiomyopathy

Stewart G. Pollock, M.D.

N Engl J Med 1994; 331:238July 28, 1994

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Article

Figure 1 Pressure Tracings in Obstructive Cardiomyopathy.

Simultaneous arterial (A) and left ventricular (LV) pressures were recorded in a patient with hypertrophic obstructive cardiomyopathy. The first three beats show a peak systolic gradient of 25 mm Hg. On the first sinus beat after a premature ventricular contraction (PVC), the peak-systolic gradient increases to over 100 mm Hg, but the pulse pressure (arterial systolic pressure minus diastolic pressure) decreases. This characteristic pattern is known as the Brockenbrough-Braunwald sign. The decrease in pulse pressure after a premature ventricular contraction is due to reduced stroke volume caused by increased dynamic obstruction, which is due, in turn, to post-extrasystolic potentiation.

Kim Eagle, M.D.

Stewart G. Pollock, M.D.
Harrisonburg Medical Associates, Harrisonburg, VA 22801

Citing Articles (3)

Citing Articles

1. 1

   Chao Y. Soon, John M. Buergler. (2008) Alcohol septal ablation and the Brockenbrough-Braunwald phenomenon. Catheterization and Cardiovascular Interventions 72:7, 1016-1024
   CrossRef

2. 2

   Joshua D. Stearns, Wilson Y. Szeto, Albert T. Cheung. (2007) Echocardiographic Evidence of the Brockenbrough???Braunwald???Morrow Sign After Mitral Valve Repair. Anesthesia & Analgesia 104:3, 502-503
   CrossRef

3. 3

   (1994) The Brockenbrough-Braunwald-Morrow Sign. New England Journal of Medicine 331:23, 1589-1590
   Full Text

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