HCM management must be tailored to the patient and varies for symptomatic/asymptomatic patients
TUESDAY, Nov. 8 (HealthDay News) -- Hypertrophic cardiomyopathy (HCM) is a common cardiovascular disorder, and following diagnosis, patients should be managed at centers of clinical excellence, according to a scientific statement published online Nov. 8 in Circulation.
Bernard J. Gersh, M.B., Ch.B., D.Phil., from the American College of Cardiology Foundation and the American Heart Association, and colleagues reviewed available literature to produce evidence-based guidelines for the diagnosis and management of HCM.
The authors reported that HCM is a common genetic cardiovascular disease with a prevalence of about one in 500. HCM is a heterogeneous cardiac disease with a broad clinical and genetic spectrum, and as such, centers of clinical excellence should be established for HCM management. Most affected individuals achieve normal life expectancy, but some have profound complications, including sudden cardiac death (SCD), heart failure, and atrial fibrillation. Clinical diagnosis usually makes use of cardiac imaging, and genetic testing assists in definitive diagnosis of affected genetic status. Various imaging modalities can be used to rule out the presence of concomitant coronary disease for correct management. Asymptomatic patients need to be educated about HCM and all patients should undergo risk stratification for SCD. Septal reduction therapy should not be undertaken for asymptomatic patients. Pharmacologic therapy is recommended for symptomatic patients, and includes beta blockers and calcium channel blockers. Invasive therapies are useful for selected patients, and include transaortic septal myectomy and a nonsurgical alternative of alcohol septal ablation. For patients at risk of SCD, implantable cardioverter-defibrillator placement should be considered.
"Treatment of patients with HCM requires a thorough understanding of the complex, diverse pathophysiology and natural history and must be individualized to the patient," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.