[Drug therapy of hypertrophic cardiomyopathy].

INTRODUCTION

Hypertrophy of the myocardium occurring in hypertrophic cardiomyopathy (HCM) may affect different locations of the left ventricle. If the hypertrophy is sited in the region of the basal septum, obstruction of the left ventricular outflow tract (hypertrophic obstructive cardiomyopathy [HOCM]) occurs. characteristic of left ventricular function in HCM is hypercontractility and disordered diastolic relaxation.

THERAPEUTIC APPROACHES

In the medical treatment of HCM, the calcium antagonists play a leading role. They improve relaxation and, through their negative inotropic effect, decrease the intraventricular gradient. Although beta-blockers reduce the gradient in outflow tract obstruction, they do not improve relaxation. In individual cases the use of diuretics and anti-arrhythmic agents may be necessary; in the case of atrial fibrillation the use of marcumar is recommended.

CAUTIONARY REMARK

In the event of dental treatment or invasive diagnostic procedures being necessary, prophylactic measures against endocarditis should be initiated.