Hypertrophic cardiomyopathy

Screening of all first-degree family members with echocardiography, ECG, and clinical follow-up is required.

All patients with HCM should:

• Be counseled about exercise (see Patient discussions).

• Undergo serial testing with echocardiogram, Holter monitor, exercise testing, and clinical evaluation to determine their risk level for sudden cardiac death (SCD); implantable cardioverter-defibrillators are indicated for prevention of SCD in selected individuals at higher risk.

• Be considered for anticoagulation for stroke prevention if they develop atrial fibrillation.

• Be referred for consideration of surgical coronary unroofing if they develop ischemia due to myocardial bridging.