THE ARTERIAL PRESSURE PULSE IN MUSCULAR SUBAORTIC STENOSIS

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Abstract
The brachial arterial pressure pulses have been analysed in 10 cases of muscular subaortic stenosis, 6 of 8 cases of discrete fixed subvalvular aortic stenosis, and 20 cases of valvular aortic stenosis. The distinguishing features in muscular subaortic stenosis were the rapid rise of pressure to an early peak systolic pressure (percussion wave), which resulted in a short systolic upstroke time to the peak systolic pressure. These characteristics contrasted with the findings in valvular and discrete fixed subvalvular aortic stenosis, where the re was a slow rise in pressure to a low percussion wave (anacrotic notch) followed by a higher tidal wave (peak systolic pressure) which resulted in a prolonged systolic upstroke time to the peak systolic pressure. The aortic pressure tracings in muscular subaortic stenosis were similar to the peripheral arterial tracing in all cases. In valvular and discrete subvalvular aortic stenosis most of the aortic tracing resembled the peripheral arterial tracing in each case, but when the catheter was near the obstruction, rapid rates of rise of pressure sometimes occurred, and these rendered differentiation from muscular subaortic stenosis less certain.

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