A young man presents with a history of chest pain. On
examination he has a jerky carotid pulse, double apical pulsation and an
ejection systolic murmur. Echocardiography demonstrates asymmetric left
ventricular hypertrophy and systolic anterior motion of the mitral valve.
In this patient, the chest pain should respond to
The patient has features of hypertrophic obstructive
. In these patients chest pain responds to treatment with beta-blockers and
verapamil either alone or in combination.
Other treatments that may be used are:
Dual chamber pacing
Alcohol ablation of the septum
Resection of septal myocardium
Revise HOCM KEYS to SUCCESS in
Medicine page 156-157