Brockenbrough Sign

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In hypertrophic obstructive cardiomyopathy there is a typical postextrasystolic pressure change in the left ventricle and in the aorta. On the beat immediately following a premature ventricular contraction:

The left ventricular systolic pressure increases.
The systolic gradient between the left ventricle and the aorta increases.
The aortic systolic pressure decreases.
The aortic pulse pressure decreases.

Palpating the carotid pulse may provide evidence of the systolic pressure drop. The amplitude of the very next beat following a premature ventricular contraction may be decreased. Normally it would be increased.

An echocardiographic technique to measure the left ventricular ejection time (LVET) in the postextrasystolic beat was shown to be more sensitive. LVET increased by more than 20 msec in eleven of twelve patients with IHSS. (Circulation 1975;52:306-312)

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