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Figure 4: In aortic stenosis, as velocity increases, acceleration decreases. In contrast, in obstructive hypertrophic cardiomyopathy (HCM), as velocity increases, acceleration also increases. In obstructive HCM, the rising pressure difference forces the mitral leaflet against the septum, which decreases the orifice size and further increases the pressure difference. Progressive orifice narrowing also explains why the jet peaks late in systole in obstructive HCM. Arrow points to the inflection point (reprinted with permission from Sherrid et al.[35] from Elsevier Inc.)

Figure 4: In aortic stenosis, as velocity increases, acceleration decreases. In contrast, in obstructive hypertrophic cardiomyopathy (HCM), as velocity increases, acceleration also increases. In obstructive HCM, the rising pressure difference forces the mitral leaflet against the septum, which decreases the orifice size and further increases the pressure difference. Progressive orifice narrowing also explains why the jet peaks late in systole in obstructive HCM. Arrow points to the inflection point (reprinted with permission from Sherrid <i>et al</i>.<sup>[35]</sup> from Elsevier Inc.)