Scientific Online Resource System

Varna Medical Forum

Therapeutic approach to idiopathic hypertrophic cardiomyopathy

Kalina Ganeva, Petar Shivachev, Lachezar Marinov, Martin Bojadziev, M. Ivanova


We`re presenting a clinical case of an 11-month old infant, who was admitted to our clinic with symptoms of congestive cardiac failure. The chest radiography and echocardiography results showed a severe symmetric hypertrophic cardiomyopathy without an obstruction in the left ventricular outflow tract. The treatment was started with Propranolol in a titrating dose until reaching the dose of 5mg/kg/24h. Several weeks later, echocardiography examination showed a significant improvement in the left ventricular diastolic function with a certain degree of regression of the myocardial hypertrophy.

The use of high doses of beta blockers together with the monitoring of the clinical state could improve the prognosis and survival in patients with idiopathic hypertrophic cardiomyopathy.

Idiopathic hypertrophic cardiomyopathy is a rare disease in childhood with a high probability of a lethal outcome. The hallmark of the disorder is myocardial hypertrophy that occurs in the absence of an obvious hemodynamic stimulus. Since the first case of an experimental treatment of an infant described in 1971, beta blockers have become one of the leading medication options with variations of the dose regimes. According to the current literature data and clinical trials, the use of beta blockers in high doses is consistent with a high percentage of survival.


hypertrophic cardiomyopathy, beta blockers, survival

Full Text


2014 ESC Guideline on diagnosis and management of hypertrophic cardiomyopathy.

2011 ACCF/AHA Guideline for diagnosis and treatment of hypertrophic cariomyopathy.

Dimitris Georgakopoulos, Vasilis Tolis: Hypertrophic cardiomyopathy in children, teenagers and young adulst; Hellenic Journal of Cariology 48:228-233,2007

Ingegerd Ostman-Smith, Goran Wettrel, Tomas Riesenfeld: A cohort study of childhood hypertrophic cariomyopathy; Journal of American college of Cardiology, 1999,Vol.34, No.6

Ingegerd Ostman-Smith, Goran Wettrel, Barry Keeton: Age-and gender-specific mortality rates in childhood hypertrophic cariomyoathy; European Heart Journal, (2008),29,1160-1167 .

Ingegerd Ostman-Smith: Hypertrophic cariomyopathy in childhood and adolescence-strategies to prevent death: Fundamental and Clinical pharmacology 24(2010),637-652.

Ingegerd Ostman-Smith: Beta-blockers in pediatric cardiomyipathies:Review on recent clinical trials, 2 Фиг. 3 014, Jun; 9(2): 82–85.



Font Size