Which drug is used for the treatment of arrhythmias in hypertrophic cardiomyopathy?
Disopyramide is a class Ia antiarrhythmic that historically was used for the treatment of arrhythmias; however, its contemporary use is often reserved for patients with HCM who are persistently symptomatic despite β-blockers or verapamil and have evidence of LVOT obstruction.
Why are ACE inhibitors contraindicated in hypertrophic cardiomyopathy?
Agents to reduce pre- or afterload (such as nitrate, ACE inhibitors, nifedipine-type calcium antagonists) are contraindicated with HOCM due to possible aggravation of the outflow tract obstruction. This often impedes therapy of coexistent arterial hypertension.
Why are diuretics contraindicated in hypertrophic cardiomyopathy?
Avoid digitalis, because glycosides are contraindicated except in patients with uncontrolled atrial fibrillation. Cautious use of diuretics should be exercised because of their potential adverse effect on the LV outflow gradient and ventricular volume.
Can cardiomyopathy be detected by an ECG?
Electrocardiogram (EKG or ECG): An EKG records the heart’s electrical activity, showing how fast the heart is beating and whether its rhythm is steady or irregular. An EKG can be used to detect cardiomyopathy as well as other problems, including heart attacks, arrhythmias (irregular heartbeats) and heart failure.
What do beta blockers do for hypertrophic cardiomyopathy?
Beta blockers decrease heart rate, reducing the heart’s workload. They prevent the worsening of obstruction that occurs with exercise, helping to decrease HCM symptoms.
How do ACE inhibitors help cardiomyopathy?
ACE inhibitors dilate the blood vessels to improve your blood flow. This helps decrease the amount of work the heart has to do. They also help block a substance in the blood called angiotensin that is made as a result of heart failure.
Why are Inotropes contraindicated in hypertrophic cardiomyopathy?
Inotropic agents (epinephrine) are contraindicated in HCM because these patients require a decreased inotropic and chronotropic state to mitigate outflow tract obstruction, diastolic dysfunction, and myocardial ischemia.
Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
Owing to their potent vasodilator effects, DHP calcium channel blockers should be avoided in symptomatic HCM patients with resting or provocable LVOT obstruction, severe systemic hypotension, or severe dyspnea at rest.
Why are beta blockers used in hypertrophic cardiomyopathy?
Are there any new treatments for hypertrophic cardiomyopathy?
Approaches such as myocardial metabolic modulation, late sodium current inhibition and allosteric myosin inhibition have moved from pre-clinical to clinical research, and reflect a surge of scientific as well as economic interest by academia and industry alike. These exciting developments, and their implications for future research, are discussed.
What are the symptoms of hypertrophic cardiomyopathy?
Clinical scenarios and symptoms associated with hypertrophic cardiomyopathy (HCM) and representation of current pharmacological (yellow balloons) and non-pharmacological treatments (orange balloons).
How is MCE used to treat hypertrophic cardiomyopathy?
The addition of myocardial contrast echocardiogram (MCE) guidance has improved such targeting and allowed sub-selective branch injection of smaller aliquots of ethanol, averaging 1-2 cc in the current era. During the procedure, success is evidenced by at least 50% reduction in peak gradient, or residual gradient <20 mm Hg.
What are the main goals of pharmacological therapy in HCM?
The main goals of pharmacological therapy in HCM include control of symptoms and exercise limitation, abolition or reduction of dynamic intraventricular gradients, treatment of LV dysfunction and heart failure (HF), control of atrial fibrillation (AF) and ventricular arrhythmias, and prevention of cardioembolism.
