Abstract
Idiopathic hypertrophic subaortic stenosis (IHSS) was found in 8 patients with angina pectoris and coronary artery disease (CAD). Three patients with coexistent IHSS and CAD were among a series of 75 patients undergoing coronary artery operations. The presence of IHSS in patients undergoing coronary artery procedures mandates avoidance of drugs that increase outflow obstruction such as cardiac glycosides, isoproterenol, nitroglycerin, and β-adrenergic vasopressors. Direct revascularization of diseased coronary arteries and pharmacological treatment of minimal and moderate outflow obstruction are suggested as effective and practical surgical management. The absence of postoperative myocardial infarctions suggests that the mechanism of symptomatic relief is increased coronary perfusion and relief of left ventricle outflow obstruction.
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