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Hypertrophic Cardiomyopathy Guidelines

ESC Clinical Practice Guidelines

Cardiovascular Surgery
Myocardial Disease
Congenital Heart Disease and Pediatric Cardiology
Device Therapy
Interventional Cardiology
Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Chronic Heart Failure
Epidemiology, Prognosis, Outcome
Guidelines version available to download
Published in 2014
Reference Eur Heart J (2014) 35:2733-2779 - doi/10.1093/eurheartj/ehu284
Published in 2014
Reference Web Addenda
Published in 2014
Reference HCM online calculator
Published in 2014
Reference 36 CME Questions
Published in 2014
Reference 2014 Takes Home Messages & Gap in Evidence
Published in 2014
Reference Summary Card for General Practice on HCM
Published in 2014
Reference HCM Pocket Guidelines Mobile App
Published in 2014
Reference Pocket Guidelines Abriged version
Published in 2014
Reference ESC-2014-Slide-set-Hypertrophic-Cardiomyopathy
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