Postprandial Ventricular Extrasystoles in Hypertropic Cardiomyopathy

What is the the cause of "Postprandial (after eating) Ventricular Extrasystoles". What is the prognosis and treatment, which will help us to manage this problem?

Current Postings (1):

• Patient, aged 59 years, diagnosed with Hypertrophic cardiomyopathy 23 yrs. ago, detected due to dyspnoea on exertion. Condition was stable with treatment of Tab Inderal (Propanolol) and later Atenolol. EKG/ECG shows left ventricular hypertrophy with strain pattern. Colour Doppler shows reversal of E/A ratio indicating diastolic dysfunction with mild sclerosis of aortic valve and apical cardiomyopathy. Systolic function normal. No left ventricular obstructive pathology. Chest X-ray - No Pulmonary Kochs. No widening of mediastinum. Both ECG and colour doppler are stable, no changes over the years. Lipid profile within normal limits with medication. No past H/O diabetes or hypertension or chest pain or dyspnoea or GERD. Mother had H/O HCM. Now having problem of Ventricular extrasystoles after food intake, each episode lasting 15 min. Current medication - Tab Atenolol 25 mg BD, Atorovastatin, Domstal(occasionally), Ecosprin. B.P. 120/70, PR - 48/mn-56/mn going to 60/mn after food intake. Cordarone -200 mg started 2 weeks ago, discontinued due to development of sinus bradycardia. Please can you enlighten on the cause of "Postprandial Ventricular Extrasystoles". What is the prognosis and treatment, which will help us to manage this problem.
Amrita, India, February 7, 2007

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