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Medicine

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Cardiology

Question
14 out of 18
 

Which of the following drugs in not contraindicated in HOCM? (LQ)



A Digoxin
B Nitrates

C Beta blocker
D Diuretics

Ans. C

Beta blocker

C. Hypertrophic cardiomyopathy (HOCM) (Ref. Hari 18th ed., Pg-1962)

1. Autosomal dominant inheritance Q sometimes sporadic.

2. Family history of sudden death may be there. (AIIMS Nov 09)

Symptoms & signs:

1. Angina;

2. Dyspnea

3. Palpitation;

4. Syncope;

5. Jerky carotid pulsationQ; f. ‘a’ wave in JVP;

6. Double apex beat Q

7. Harsh ejection systolic murmur. QThe intensity of murmur increase on standing, Valsalva, Amyl nitrate inhalation Q (FAQ) (AIIMS Nov 09)

Note: Murmur of HOCM decreases with hand grip.

Tests:

ECG: LVH;

Echo: asymmetrical septal hypertrophy; small LV cavity with hypercontractile posterior wall; midsystolic closure of aortic valve; systolic anterior movement of mitral valve Q. (SAM)

Management:

1. Beta-blockers or verapamil.

2. Amiodarone for arrhythmias (AF, VT).

2. Septal myotomy (surgical, or chemical. with alcohol Q,)

Drugs contraindicated (AIIMS Nov 11)

1. Digoxin

2. Nitrates

3. Beta agonist

4. Diuretics

Cardiology Flashcard List

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