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Hypertrophic Cardiomyopathy

ESC Clinical Practice Guidelines

Congenital Heart Disease in Children and Adults
Myocardial Disease
Guidelines version available to download
Published in2014
ReferenceEur Heart J (2014) 35:2733-2779 - doi/10.1093/eurheartj/ehu284
Published in2014
ReferenceWeb Addenda
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ReferenceHCM online calculator
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Reference36 CME Questions
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Reference2014 Takes Home Messages & Gap in Evidence
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ReferenceSummary Card for General Practice on HCM
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    ReferenceHCM Pocket Guidelines Mobile App
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    ReferencePocket Guidelines Abriged version
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    Table of contents: Full Text (ESC Clinical Practice Guidelines)



    1. Definition
    2. Scope of Guidelines



    1. Sarcomere protein gene mutations
    2. Metabolic disorders
    3. Mitochondrial cardiomyopathies
    4. Neuromuscular disease
    5. Malformation syndromes
    6. Infiltrative disease/inflammation
    7. Endocrine disorders
    8. Drugs


    1. Diagnostic criteria
      1. Adults
      2. Children
      3. Relatives
    2. History and physical examination
    3. Resting and ambulatory electrocardiography
    4. Echocardiography
      1. Assessment of left ventricular wall thickness
      2. Associated abnormalities of the mitral valve and left ventricular outflow tract
      3. Assessment of latent obstruction
      4. Left atrial enlargement
      5. Assessment of diastolic function
      6. Systolic function
      7. Role of echocardiography in differential diagnosis
      8. Contrast echocardiography
      9. Transoesophageal echocardiography
    5. Cardiovascular magnetic resonance imaging
      1. Assessment of ventricular morphology and function
      2. Myocardial fibrosis
      3. Role in prognosis
      4. Differential diagnosis
    6. Nuclear imaging
    7. Endomyocardial biopsy
    8. Laboratory tests

    Genetic testing and family screening

    1. Counselling in probands
    2. Methods for molecular genetic screening in probands
    3. Indications for genetic testing in probands
    4. Genetic and clinical screening of relatives
      1. Families with definite genetic mutations
      2. Families without definite genetic mutations
    5. Genetic and clinical screening of children
    6. Follow-up of mutation carriers without a phenotype
    7. Pre-implantation and pre-natal genetic testing

    Delivery of care

    1. Education and training

    Assessment of symptoms

    1. Chest pain
    2. Heart failure
      1. Invasive pressure studies
      2. Cardiopulmonary exercise testing
    3. Syncope
    4. Palpitations
    5. Role of electrophysiological testing

    Management of symptoms and complications

    1. Left ventricular outflow tract obstruction
      1. General measures
      2. Drug therapy
      3. Invasive treatment of left ventricular outlow tract obstruction
    2. Mid-cavity obstruction and apical aneurysms
    3. Management of symptoms in patients without left ventricular outlow tract obstruction
      1. Heart failure
      2. Angina
    4. Atrial tachyarrhythmia
      1. Acute treatment
    5. Sudden cardiac death
      1. Clinical risk assessment
      2. Models for estimating sudden cardiac death
      3. Prevention of sudden cardiac death
      4. Risk of sudden death in children
    6. Symptomatic bradycardia and atrioventricular block
    7. Ventricular tachycardia

    Recommendations for routine follow-up

    Reproduction and contraception

    1. Introduction
    2. Contraception and termination of pregnancy
    3. Infertility treatment
    4. Pre-conception counselling
    5. Management of pregnancy and delivery

    Special issues

    1. Diagnosis of hypertrophic cardiomyopathy in athletes
    2. Hypertension
      1. Imaging
      2. Electrocardiogram
    3. Isolated basal septal hypertrophy (sigmoid septum) in elderly people
    4. Diagnosis and management of valve disease in patients with hypertrophic cardiomyopathy
      1. Aortic valve disease
      2. Mitral valve disease
      3. Endocarditis prophylaxis

    Living with cardiomyopathy: advice to patients






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    European Society
    of Cardiology

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