Beneficial effects of disopyramide on left ventricular outflow obstruction in a case of hypertrophic obstructive cardiomyopathy

: The Authors describe a patient with hypertrophic cardiomyopathy (HCM), severe left ventricular outflow tract obstruction and lack of response to beta-blockers or verapamil. Intravenous infusion of disopyramide resulted in a virtual disappearance of the LV pressure gradient, reduction of the systolic anterior motion of the mitral valve and slowing of the LV isovolumetric relaxation. One month after maintenance therapy with oral disopyramide a decrease of the anginal episodes and an improvement of the exercise tolerance were noted. Thus disopyramide, probably because of its negative inotropic action, is useful in the management of patients with HCM when LV outflow obstruction is the main cause of the clinical-hemodynamic findings.