The morphological aspect of the carotid pulse has been under study in 47 cases of juxtavalvular aortic stenosis previously confirmed through hemodynamic and surgical examinations. The study included 39 cases of subvalvular fibrous stenosis (subaortic fibrous stenosis) (SAsV) and 8 cases of supravalvular annular aortic stenosis (S AsV). In 75% of both SAsV and SAsV cases the carotid pulse showed a rapid ascent and a finely notched apex, while in 25% of the cases it followed the pattern of a typical valvular stenosis. This is more obvious for the left carotid artery. The morphology of the carotid pulse resulted as independent from the aortic ventricular gradient, but, on the other hand, connected with the simultaneous stenotic involvement of the valvular cusps. The sign possesses not only high sensitivity but also high specificity with regard to juxtavalvular aortic stenoses because it has only been met with in 2 cases of valvular aortic stenosis. The pathophysiological explanation remains as yet obscure.
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