Hypertrophic Cardiomyopathy Guidelines Updated

The US guideline for the management of hypertrophic cardiomyopathy (HCM) have been updated. The top 10 take-home messages are: Shared decision-making is essential to provide the best clinical care. Referral to multidisciplinary HCM centers with appropriate expertise can be important to optimizing care for patients with HCM. Careful ascertainment of family history, counseling patients with HCM about the potential for genetic transmission of HCM, and options for genetic testing are cornerstones of care. Assessing a patient’s risk for sudden cardiac death is an important component of management. The risk factors for sudden cardiac death in children with HCM carry different weights and components than those used in adult patients. Cardiac myosin inhibitors are now available to treat patients with symptomatic obstructive HCM. Invasive septal reduction therapies (surgical septal myectomy and alcohol septal ablation) can provide safe and effective symptomatic relief for patients with drug-refractory or severe outflow tract obstruction. Patients with HCM and atrial fibrillation have a sufficiently increased risk of stroke such that anticoagulants should be considered the default treatment option. Exercise stress testing is particularly helpful in determining overall exercise tolerance and for latent exercise provoked left ventricular outflow tract obstruction. Increasingly, data affirm that the beneficial effects of exercise on general health are extended to patients with HCM. Source: https://www.jacc.org/