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Disopyramide as a negative inotrope in obstructive cardiomyopathy in children
W J Duncan1, M J Tyrrell, B B Bharadwaj
1University of Saskatchewan, Saskatoon.
Insights
Disopyramide effectively treated left ventricular outflow tract obstruction in two children with myocardial hypertrophy. Oral disopyramide rapidly improved clinical signs and reduced obstruction, showing promise for pediatric dynamic muscular subaortic obstruction.
Area of Science:
- Cardiology
- Pediatric Medicine
- Pharmacology
Background:
- Left ventricular outflow tract obstruction (LVOTO) due to myocardial hypertrophy can significantly impact pediatric cardiac function.
- Dynamic muscular subaortic obstruction presents a therapeutic challenge in children.
Observation:
- Two pediatric patients with severe LVOTO secondary to myocardial hypertrophy were treated with oral disopyramide.
- Disopyramide was administered as a negative inotropic agent.
Findings:
- Both children demonstrated rapid clinical improvement following disopyramide administration.
- Echocardiography Doppler examinations confirmed a near-complete abolition of severe LVOTO in both cases.
- Disopyramide acted as an effective negative inotrope, reducing obstruction.
Implications:
- This case series suggests disopyramide may be a valuable therapeutic option for pediatric patients with dynamic muscular subaortic obstruction.
- Further clinical trials are warranted to explore the broader application of disopyramide in managing pediatric LVOTO.
Abstract:
Two children with left ventricular outflow tract obstruction due to myocardial hypertrophy received oral disopyramide as a negative inotrope. Both showed rapid improvement in clinical signs and by echo Doppler examination. Nearly complete abolition of severe left ventricular outflow tract obstruction was documented in each case. This experience may prompt further application of disopyramide as a therapeutic agent to relieve dynamic muscular subaortic obstruction in children.