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Patient, aged 59 years, diagnosed with HypertrophicHypertrophic cardiomyopathy cardiomyopathy 23 yrs. ago, detected due to dyspnoea on exertion. Condition was stableStable angina Unstable angina with treatment of Tab InderalInderal Inderal la (Propanolol) and later AtenololAtenolol Atenolol-chlorthalidone.
EKGAtrioventricular block, ekg tracing Ecg Exercise stress test/ECG shows left ventricular hypertrophy with strain pattern.
Colour Doppler shows reversal of E/A ratio indicating diastolic dysfunction with mild sclerosis of aortic valve and apical cardiomyopathy. Systolic function normal. No left venticular obstructive pathology.
Chest X-ray - No Pulmonary Kochs. No widening of mediastinum.
Both ECG and colour doppler are stable, no changes over the years.
Lipid profile within normal limits with medication.
No past H/O of diabetes or hypertension or chest pain or dyspnoea or GERD.
Mother had H/O of HCM.
Now having problem of Ventricular extrasystoles after food intake, each episode lasting about 15 min & then reducing spontaneously.
Current medication - Tab Atenolol 25 mg BD, Atorovastatin, Domstal(occasionally), Ecosprin.
B.P. 120/70, Pulse - 48/mn-56/mn going to 60/mn after food.
Cordarone -200 mg started 2 weeks ago, discontinued due to development of sinus bradycardia