Beta-adrenergic Blockade in Hypertrophic Obstructive Cardiomyopathy

Abstract

This paper deals with our experience with beta-adrenergic blockade in patients with hypertrophic obstructive cardiomyopathy investigated at the Hammersmith Hospital and Post-graduate Medical School. Acute studies showed little or no effect on resting gradients. Beta-adrenergic blockade was, however, effective in decreasing or abolishing the increase in outflow gradient resulting from exercise or isoprenaline infusion. Long-term studies in 13 patients showed subjective improvement in 10. Objective signs did not always parallel the improvement, though there was often a decrease in the intensity of the murmur due to an increase in heart size. This is a preliminary report, and suggests that beta-adrenergic blockade may be of value in the long-term management of patients with hypertrophic obstructive cardiomyopathy. Longer studies in a larger group of patients are indicated before any firm conclusions can be drawn. A warning note is sounded concerning the importance of establishing a firm diagnosis before embarking on treatment. © 1966, British Medical Journal Publishing Group. All rights reserved.