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Diagnostic Value of the Configuration of the Transaortic Pressure Gradient for the Differentiation Between Idiopathic Hypertrophic Subaortic Stenosis and the Discrete Forms of Left Ventricular Outflow Obstruction.

Dean T. Mason, M.D., F.A.C.P.; Lawrence S. Cohen, M.D.; James F. Spann Jr., M.D.; and Eugene Braunwald, M.D., F.A.C.P.
Ann Intern Med. 1968;68(5):1159. doi:10.7326/0003-4819-68-5-1159_1
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Since the obstruction in idiopathic hypertrophic subaortic stenosis (IHSS) is dynamic, whereas that in discrete aortic stenosis (AS) is fixed, it was considered that the shape of the transaortic pressure gradient might be altered in IHSS and, thereby, provide a means of differentiating these two conditions. In 22 patients with IHSS the peak of the arterial pulse always occurred in the initial half of the systolic ejection period, while in 37 of 40 patients with AS it appeared in the final half. Peak left ventricular pressure was delayed significantly (P < 0.01) in IHSS compared to AS; the interval from


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