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External carotid pulse recordings in hypertrophic obstructive cardiomyopathy
Acta Medica Scandinavica
|January 1, 1977
Summary
Carotid pulse tracings are valuable for diagnosing hypertrophic obstructive cardiomyopathy (HOCM). Specific pulse patterns, like midsystolic dipping, indicate left ventricular outflow obstruction in HOCM patients.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) is a complex cardiac condition.
- Accurate diagnosis and monitoring of left ventricular outflow obstruction are crucial for HOCM management.
Purpose of the Study:
- To evaluate the diagnostic utility of external carotid pulse tracings in patients with suspected HOCM.
- To correlate pulse wave characteristics with the severity of intraventricular gradients.
Main Methods:
- Analysis of external carotid pulse tracings in 15 patients diagnosed with HOCM via left heart catheterization.
- Observation of pulse wave morphology, including upstroke velocity and presence of midsystolic dipping.
Main Results:
- A typical bifid pulse with midsystolic dipping was observed in 9 out of 12 patients with resting intraventricular gradients.
- Midsystolic dipping also occurred in beats following extrasystoles in one patient without a resting gradient (Brockenbrough phenomenon).
- Rapid pulse wave upstroke distinguished HOCM from valvular aortic stenosis; left ventricular ejection time showed correlation with gradients but was not consistently indicative of HOCM.
Conclusions:
- Carotid pulse registration offers significant diagnostic value for suspected HOCM.
- Observed pulse changes correlate with left ventricular outflow obstruction, suggesting potential for serial tracings in monitoring disease progression and treatment efficacy.