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Diagnosis of Hypertrophic Subaortic Stenosis with a Doppler Velocity Flow Detector

[+] Article, Author, and Disclosure Information

Supported by grants from the John A. Hartford Foundation, New York, N.Y.; and grants HE5239 and HE08805, U.S. Public Health Service, Washington, D.C.

We are indebted to Dr. James G. Shelburne for catheterization studies in two of these patients, to Dr. Paul D. Thompson for engineering assistance, and to Mr. N. Joseph Montello, Miss Mary Piscopo, and Mrs. Mary Anne Drew for their technical assistance.

▸Requests for reprints should be addressed to Claude R. Joyner, Jr., M.D., 950 Gates Pavilion, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, Pa. 19104

Philadelphia, Pennsylvania

Ann Intern Med. 1971;74(5):692-696. doi:10.7326/0003-4819-74-5-692
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A transcutaneous Doppler velocity probe was used to record phasic carotid artery flow in 12 patients with hypertrophic subaortic stenosis. In contrast to the normal Doppler flow pattern of a single large orthograde systolic wave, all patients demonstrated a distinctively abnormal flow profile. A sharp wave of rapid, early systolic flow was followed by an abrupt decrease of flow in midsystole with a slower phase of late systolic flow. In 4 of the 12 patients the distinctively abnormal Doppler flow pattern was found in the absence of the characteristic sharp percussion and low tidal wave carotid pulse contour often present in hypertrophic subaortic stenosis. The Doppler recording of phasic carotid flow seems valid for the clinical evaluation of this disease, since the abnormal abrupt decrease in midsystolic flow was not found in the study of 94 patients presenting with other cardiovascular disease.





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