title: Attenuation of biventricular pressure gradients by cibenzo-line in an 18-year-old patient with hypertrophic obstructive cardiomyopathy.
abstract: An 18-year-old male patient with biventricular hypertrophic obstructive cardiomyopathy (HOCM) had successful reduction of the pressure gradients by cibenzoline. At 11 months after birth, he was first diagnosed with cardiac murmurs and by the age of 5 years, he was diagnosed with subpulmonic infundibular stenosis with a pressure gradient of 10 mmHg by cardiac catheterization. At the age of 14, re-catherterization revealed hypertrophic cardiomyopathy with isolated obstruction of the right ventricular outflow tract, with a pressure gradient of 70 mmHg, but no obstruction in the left ventricle. He began daily treatment with 30 mg propranolol. At the age of 18, he was admitted for cardiac evaluation. An echocardiogram revealed left mid-ventricular and subpulmonic obstructions associated with pressure gradients of 88 mmHg and 65 mmHg, respectively. A single oral dose of 200 mg of cibenzoline decreased the pressure gradients in the left and right ventricles (38 mmHg and 36 mmHg, respectively). He was then given 300 mg daily of cibenzoline, and both pressure gradients remained low without any complications 8 months later at the time of discharge.
authors.affiliation: The Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Hiasa
authors.forename: Mareomi
authors.initials: M
authors.lastname: Hamada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hara
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogimoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Saeki
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Matsunaka
authors.forename: Hironobu
authors.initials: H
authors.lastname: Hamada
authors.forename: Takafumi
authors.initials: T
authors.lastname: Okura
authors.forename: Kunio
authors.initials: K
authors.lastname: Hiwada
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D011877:Radionuclide Imaging; D016896:Treatment Outcome; D018754:Ventricular Dysfunction / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; C032151:cifenline