2 CASES OF HYPERTROPHIC CARDIOMYOPATHY WITH CORONARY VASOSPASM

Chest pain in patients with hypertrophic cardiomyopathy seems to be ca used by relative myocardial ischemia due to the left ventricular outfl ow pressure gradient and myocardial hypertrophy. However, in 2 cases o f hypertrophic cardiomyopathy chest pain was associated with coronary vasospasm. Thus, chest pain in these cases was decreased not by a beta -blocker but by isosorbide dinitrate and a calcium antagonist. Because beta-blockers are commonly used for hypertrophic obstructive cardiomy opathy and chest pain may be aggravated by beta-blockers in patients w ith coronary vasospasm, a combination of beta-blocker, isosorbide dini trate and calcium antagonist was necessary for this hypertrophic cardi omyopathy with variant angina.