The Brockenbrough-Braunwald-Morrow Sign: Understanding LVOT Obstruction in HCM
This engaging CardioNerds illustration breaks down the Brockenbrough-Braunwald-Morrow sign, highlighting the hemodynamic dynamics in Hypertrophic Cardiomyopathy (HCM). The artwork uses characters to explain how premature ventricular contractions (PVCs) influence left ventricular outflow tract (LVOT) behavior.
Key Highlights:
Compensatory Pause After PVC:
- Prolonged filling time increases end-diastolic volume (EDV), triggering the Frank-Starling mechanism to enhance contractility.
Hemodynamic Response in HCM:
- Augmented inotropic response combined with reduced afterload exacerbates LVOT obstruction, creating a spike-and-dome arterial pulse pattern.
Differentiating Aortic Stenosis vs. HCM:
- Both conditions elevate LV systolic pressure, but aortic stenosis shows a slurred pulse upstroke, while HCM features dynamic pulse changes with the spike-and-dome morphology.
Illustrated by: Dr. Sukriti Banthiya
Reviewed by:
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