Left ventricular outflow tract obstruction unmasked by nifedipine: a therapeutic pitfall in the management of chronic aortic regurgitation.
This case report illustrates the aggravation of a clinically silent left ventricular outflow tract obstruction by maintenance use of nifedipine in a patient with chronic severe aortic regurgitation, and demonstrates a potential limitation of vasodilator therapy in the management of this patient population. Recognition of this clinical scenario is imperative, as decision making in patients with chronic severe aortic regurgitation rests on the development of symptoms and/or left ventricular dysfunction in relation to the regurgitant volume. The importance of echocardiography in the detection of this valvular finding and in the follow up of these patients is emphasized.
Novaro
G M
GM
Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA.
Rodriguez
L L
LL
D001022:Aortic Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D002908:Chronic Disease; D004452:Echocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects*; D014665:Vasodilator Agents / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy; D014694:Ventricular Outflow Obstruction / Q000209:etiology*
D014665:Vasodilator Agents; D009543:Nifedipine