Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a unique cardiovascular condition associated with many different genetic mutations that result in a variety of phenotypes and variable clinical presentations at any age. Fortunately, HCM patients at high risk for sudden cardiac death constitute only a small proportion of the affected population. Despite the wide spread availability of genetic screening tests, the diagnosis of HCM remains primarily clinical and echocardiographic, based on symptoms and characteristic features, such as asymmetric septal hypertrophy, systolic anterior motion (SAM) of the mitral valve, and left ventricular outflow tract (LVOT) obstruction. In the setting of symptoms refractory to optimal medical management, surgical myectomy continues to be the gold standard therapy for HCM in appropriately risk-stratified patients in areas where an experienced team and facility are available. Alcohol septal ablation provides an excellent alternative treatment modality when performed in appropriately selected patients in an experienced center.