Treatment Guideline Chart

Hypertrophic cardiomyopathy is a genetically determined cardiac disorder characterized by hypertrophy, often of the left ventricle (LV), with nondilated ventricular chambers and no other cardiac or systemic disease (eg aortic stenosis, thyroid disease or hypertension) capable of producing the extent of hypertrophy manifested by the patient.

Symptoms can range from patients being asymptomatic to mildly or significantly symptomatic with pre-syncopal or syncopal episodes, palpitations, chest pain, decreased exercise tolerance, symptoms of pulmonary congestion (eg fatigue, dyspnea, orthopnea and paroxysmal nocturnal dyspnea) and symptoms of end-stage heart failure.

Approach to treatment is based on clinical experience and observational data as large randomized trials regarding medical therapy in hypertrophic cardiomyopathy are lacking.

An empiric therapy is often necessary to identify the best possible drug for the patient, starting at a low dose and titrating until clinical improvement or occurrence of side effects.

Treat comorbidities such as hypertension, diabetes, obesity and hyperlipidemia according to existing guidelines due to the significant influence of concomitant coronary artery disease on the survival of patients with hypertrophic cardiomyopathy.


Hypertrophic%20cardiomyopathy Patient Education

Lifestyle Modification

  • Avoid alcohol and caffeine
  • Adequate hydration in patients with no evidence of fluid overload
  • Advise regarding smoking and its health risks
  • Maintain a healthy BMI
  • Appropriate diet and exercise
    • In patients with LVOTO, large meals can cause chest pain, thus small frequent meals may be of help
    • Low-intensity aerobic exercise is advised
    • Intense competitive athletics is avoided as sudden cardiac arrest is thought to be caused by increases in catecholamine levels
    • Low-intensity sports and activities are reasonable, eg brisk walking, bowling, golf, skating, snorkeling
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