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?
Patients should be educated on the avoidance of certain medications (i.e., high-dose diuretics, vasodilators, inotropes) that
may cause vasodilation
, thereby exacerbating the degree of obstruction. In symptomatic HCM, goals of therapy include alleviating exertional dyspnea, palpitations, and chest discomfort.
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
.
Why dobutamine is contraindicated in hypertrophic cardiomyopathy?
The use of dobutamine or arbutamine is contraindicated in patients with idiopathic hypertrophic subaortic stenosis (IHSS). Dobutamine or arbutamine
may increase the pressure gradient within the left ventricle and thereby worsen cardiac output
in patients with IHSS.
Why are beta blockers used in Hocm?
Beta Blockers
They
prevent the worsening of obstruction that occurs with exercise
, helping to decrease HCM symptoms. These medications work by blocking the hormone adrenaline from increasing the heart rate in response to stress or exercise, also known as the “fight or flight” reaction.
Can you live a long life with hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy (HCM) is
consistent with survival to normal life expectancy
, including particularly advanced age into the tenth decade of life, with demise ultimately largely unrelated to this disease, according to a study being presented Nov.
What are 4 signs of cardiomyopathy?
- Shortness of breath or trouble breathing, especially with physical exertion.
- Fatigue.
- Swelling in the ankles, feet, legs, abdomen and veins in the neck.
- Dizziness.
- Lightheadedness.
- Fainting during physical activity.
- Arrhythmias (irregular heartbeats)
What medication is used for hypertrophic cardiomyopathy?
Medications to treat hypertrophic cardiomyopathy and its symptoms may include: Beta blockers such as
metoprolol (Lopressor, Toprol-XL)
, propranolol (Inderal, Innopran XL) or atenolol (Tenormin) Calcium channel blockers such as verapamil (Verelan, Calan SR,) or diltiazem (Cardizem, Tiazac)
How do you improve hypertrophic cardiomyopathy?
- Exercise as Recommended. Regular exercise reduces heart rate and blood pressure and provides overall health benefits. …
- Monitor Blood Pressure. …
- Eat Healthfully. …
- Limit Alcohol Consumption. …
- Control Diabetes. …
- Manage Stress. …
- Quit Smoking.
Why is digoxin contraindicated in hypertrophic obstructive cardiomyopathy?
Digoxin can
increase inotropy
which may exacerbate heart symptoms in patients with HCM that have preserved systolic function. In patients that have refractory AF with rapid ventricular rates, atrioventricular node ablation and permanent pacing is an alternative.
What are the contraindications of dobutamine?
The medication is contraindicated in patients with
acute myocardial infarction
, unstable angina, left main stem disease, severe hypertension, arrhythmias, acute myocarditis or pericarditis, hypokalemia and idiopathic hypertrophic sub-aortic stenosis.
Is dobutamine used for hypertension?
Dobutamine is a
direct-acting inotropic agent
whose primary activity results from stimulation of the ß receptors of the heart while producing comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects.
What is the antidote for dobutamine?
Side effects of dobutamine can be reverted by
metoprolol (1–5 mg)
or esmolol intravenously, if chest pain or arrhythmias do not resolve after termination of dobutamine infusion.
Which beta blocker is best for Hocm?
Five different beta-blockers have been used in 12 studies in HCM.
Propranolol
was first studied in four early trials. One trial compared nadolol (beta-blocker) to verapamil (non-dihydropyridine calcium channel blocker) and found nadolol to be superior in terms of symptomatic relief.
What does Hocm stand for?
Hypertrophic cardiomyopathy
is usually caused by abnormal genes (gene mutations) that cause the heart muscle to grow abnormally thick. In most people with hypertrophic cardiomyopathy, the muscular wall (septum) between the two bottom chambers of the heart (ventricles) becomes thicker than normal.
Can HCM cause bradycardia?
All family members underwent a medical history, physical examination, electrocardiography (ECG), and echo- cardiographic examinations. Four individuals had manifested nonobstructive HCM with severe bradyarrhythmias, including sinus bradycardia and atrioventricular conduction block.
