Infographics: The Brockenbrough – Braunwald – Morrow Sign


The Brockenbrough-Braunwald-Morrow Sign: Understanding LVOT Obstruction in HCM

This engaging CardioNerds illustration breaks down the Brockenbrough-Braunwald-Morrow sign, highlighting the hemodynamic dynamics in Hypertrophic Cardiomyopathy (HCM). The artwork uses characters to explain how premature ventricular contractions (PVCs) influence left ventricular outflow tract (LVOT) behavior.

Key Highlights:

Compensatory Pause After PVC:

    • Prolonged filling time increases end-diastolic volume (EDV), triggering the Frank-Starling mechanism to enhance contractility.

    Hemodynamic Response in HCM:

      • Augmented inotropic response combined with reduced afterload exacerbates LVOT obstruction, creating a spike-and-dome arterial pulse pattern.

      Differentiating Aortic Stenosis vs. HCM:

        • Both conditions elevate LV systolic pressure, but aortic stenosis shows a slurred pulse upstroke, while HCM features dynamic pulse changes with the spike-and-dome morphology.

        Illustrated by: Dr. Sukriti Banthiya
        Reviewed by:


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