Treatment with 300 mg/day of cibenzoline successfully prevented the recurrence of flash pulmonary edema driven by latent left ventricular outflow tract obstruction and acute mitral regurgitation.
Case Report (n=1)
No
Dobutamine stress echocardiography can unmask latent LVOT obstruction and SAM-induced mitral regurgitation in patients with hypertensive heart disease and refractory diastolic heart failure, which can be effectively treated with cibenzoline.
In a 57-year-old woman who was referred as refractory diastolic heart failure, dobutamine stress echocardiography facilitated the diagnosis of acute worsening of mitral regurgitation accompanied with latent left ventricular outflow tract obstruction as a cause of recurrent flash pulmonary edema. Echocardiography revealed the presence of sigmoid septum and concentric left ventricular hypertrophy, being consistent with hypertensive heart disease. Dobutamine induced systolic anterior motion of the mitral valve (SAM) with massive mitral regurgitation, resulting in sudden hypotension with dyspnea. The class Ia antiarrhythmic drug, cibenzoline, reduced the SAM during a dobutamine stress test, followed by no recurrence of flash pulmonary edema.
Fujino et al. (Thu,) conducted a case report in Diastolic heart failure and hypertensive heart disease (n=1). Cibenzoline was evaluated on Recurrence of flash pulmonary edema. Treatment with 300 mg/day of cibenzoline successfully prevented the recurrence of flash pulmonary edema driven by latent left ventricular outflow tract obstruction and acute mitral regurgitation.