Summary
Definition
History and exam
Key diagnostic factors
- family history of HCM
- history of presyncope or syncope
- systolic ejection murmur
- left ventricular lift (heave)
- double apical impulse or double carotid pulsation
- family history of sudden death
Other diagnostic factors
- younger male (<50 years)
- dyspnea
- angina
- palpitations
- irregularly irregular pulse
- older female (>50 years)
- collapse
- fourth heart sound
Diagnostic tests
1st tests to order
- ECG
- creatine kinase (CK)
- liver function tests
- renal function tests
- N-terminal pro-brain natriuretic peptide (NT-proBNP)
- troponin
- urinalysis
- CXR
- transthoracic echocardiography with Doppler
Tests to consider
- exercise ECG
- Holter monitoring
- nuclear imaging exercise test
- cardiac magnetic resonance (CMR)
- cardiac computed tomography (CT)
- CT coronary arteriography
- cardiac catheterization
- stress echocardiography
- exercise echocardiography
- transesophageal echocardiography
- endomyocardial biopsy
- genetic mutation analysis
Treatment algorithm
Contributors
Authors
Theodore Abraham, MD
Professor of Medicine and Radiology
Meyer Friedman Distinguished Professor of Medicine
Co-director, UCSF HCM Center of Excellence
University of California
San Francisco
CA
Disclosures
TA serves as a steering committee member/local investigator and his institution has received research funding for hypertrophic cardiomyopathy-related clinical trials sponsored by Bristol Myers Squibb; Cytokinetics Inc.; Tenaya Pharmaceuticals; and Imbria Pharmaceuticals.
Acknowledgements
Dr Theodore Abraham would like to gratefully acknowledge Dr Monica Mukherjee, Dr Melanie D. Everitt, and Dr Anji T. Yetman, previous contributors to this topic.
Disclosures
MM, MDE, and ATY declare that they have no competing interests.
Peer reviewers
Radhika Kuna, MD
Fellow
Division of Cardiology
University of Maryland Medical Center
Baltimore
MD
Disclosures
RK declares that she has no competing interests.
Saidi Mohiddin, BSc, MBChB
Consultant Cardiologist/Head of Unit
Heart Muscle Disease Unit
Barts and The London NHS Trust
London
UK
Disclosures
SM declares that he has no competing interests.
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