Cardio-selective Beta-adrenergic Therapy in a Patient with Asthma and Hypertrophic Obstructive Cardiomyopathy

A patient is described with the unusual combination of severe asthma and hypertrophic obstructive cardiomyopathy. Cardioselective β -adrenergic therapy was instituted using the β -1 antagonist pindolol and the β -2 agonist albuterol. Pindolol proved effective as a β -1 antagonist; however, its use was precluded by deterioration in pulmonary function demonstrating moderate β -2 antagonistic properties. Albuterol was an effective β -2 agonist producing sustained bronchodilation without inducing symptoms related to the hypertrophic obstructive cardiomyopathy.