Postprandial Ventricular Extrasystoles in Hypertropic Cardiomyopathy
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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. |
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