Pickelhaube Sign on Echocardiogram Pickelhaube sign may be seen in mitral valve prolapse (MVP): High velocity (≥ 16 cm/s) systolic signal with tissue Doppler imaging resembling the Pickelhaube (Spiked helmet worn in the 19th and 20th centuries by Prussian and German military) Mechanism: the tugging of the posteromedial papillary muscle in mid-systole by the myxomatous prolapsing leaflets causes the adjacent posterobasal LV wall to be pulled sharply toward the apex Significance: indicates malignant phenotype of myxomatous mitral valve disease (MMVD) and bileaflet MVP Abhilash Koratala MD @NephroP #Pickelhaube #Sign #Echocardiogram #POCUS #cardiology #clinical #diagnosis
