title: Improvement in indices of myocardial ischaemia in a case of hypertrophic obstructive cardiomyopathy treated with verapamil.
abstract: A 42-year-old male with hypertrophic obstructive cardiomyopathy presented with blackouts and chest pain. Investigations revealed no occlusive coronary artery disease. Treadmill exercise electrocardiography and thallium-201 imaging revealed reversible myocardial ischaemia. Exercise radionuclide ventriculography (RNV) revealed exercise-induced apical hypokinesia but normal diastolic function. Chronic therapy with Verapamil (120 mg tds) produced a symptomatic improvement, increased exercise tolerance and improved indices of myocardial ischaemia, without altering diastolic function as assessed by radionuclide ventriculography. This improvement may have been mediated by altering slow channel calcium metabolism, possibly at a microvascular level.
mesh_terms: D000328:Adult; D004562:Electrocardiography; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D011868:Radioisotopes; D013793:Thallium; D014700:Verapamil