Brockenbrough-Braunwald-Morrow sign
Contents
Brockenbrough-Braunwald-Morrow sign seen in
[A] Tetralogy of Fallot
[B] Mitral Valve Prolapse
[C] HOCM
[D] Pericardial Tamponade
Brockenbrough-Braunwald-Morrow sign
Published in Methodist DeBakey Cardiovascular Journal 2014 – Alejandro TrevinoJ. Buergler
All of the following are TRUE EXCEPT for the phenomena in above image
[A] Post PVC beat there is Paradoxical decline in arterial pulse pressure
[B] Post PVC Concomitant fall in left ventricular systolic pressure
[C] Seen in HOCM
[D] Post ectopic beat vigorous contraction increases the systolic obstruction and lowers systolic pressure
Mechanism of Brockenbrough-Braunwald-Morrow sign
Ectopic atrial and ventricular beats
- Ectopic atrial and ventricular beats are associated with a prolonged compensatory pause.
- During this pause, more extracellular calcium enters the cardiac muscle cells and gets stored in the sarcoplasmic reticulum.
- Increased concentrations of calcium in myocardial cells cause hypercontractility.
- This leads to a higher systolic and pulse pressure in normal hearts.
In HOCM – vigorous contraction in the post ectopic beat
- Increases the systolic obstruction
- Lowers systolic pressure and pulse pressure