“Spike and dome” pulse


“Spike and dome” pulse seen in

[A] MVP
[B] Mitral Regurgitation
[C] DCM
[D] HOCM



“Spike and dome” pulse


HOCM


The spike and dome pattern is due to the


  • SPIKE – Rapid rise in aortic pressure during the early systole (due to the percussion wave)
  • DOME – Mid-systolic drop followed by the secondary or tidal wave.

Rapid rise in aortic pressure during the early systole (due to the percussion wave) followed by a mid-systolic drop followed by the secondary or tidal wave.


Mid systolic drop in amplitude of the pulse wave is due to a decrease in forward flow related to mid systolic obstruction which is in turn caused by the systolic anterior motion of the anterior mitral leaflet. 


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