Two cases of hypertrophic cardiomyopathy with coronary vasospasm.
Chest pain in patients with hypertrophic cardiomyopathy seems to be caused by relative myocardial ischemia due to the left ventricular outflow pressure gradient and myocardial hypertrophy. However, in 2 cases of hypertrophic cardiomyopathy chest pain was associated with coronary vasospasm. Thus, chest pain in these cases was decreased not by a beta-blocker but by isosorbide dinitrate and a calcium antagonist. Because beta-blockers are commonly used for hypertrophic obstructive cardiomyopathy and chest pain may be aggravated by beta-blockers in patients with coronary vasospasm, a combination of beta-blocker, isosorbide dinitrate and calcium antagonist was necessary for this hypertrophic cardiomyopathy with variant angina.
Konishi
T
T
Department of Cardiology, Tenri Hospital, Tenri City, Nara, Japan.
Kondou
H
H
Tamura
T
T
Izumi
C
C
Inoko
M
M
Kitaguchi
S
S
Himura
Y
Y
Iga
K
K
Gen
H
H
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000788:Angina Pectoris, Variant / Q000188:drug therapy* / Q000209:etiology*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000188:drug therapy; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003329:Coronary Vasospasm / Q000150:complications* / Q000188:drug therapy; D004110:Diltiazem / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D004110:Diltiazem; D007548:Isosorbide Dinitrate