Investigation and treatment of hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy is a common genetically transmitted disease, defined clinically by the presence of left ventricular hypertrophy in the absence of loading conditions sufficient to cause the observed degree of hypertrophy. The disease has a heterogeneous clinical course, with many patients having few cardiovascular symptoms and others profound exercise limitation and recurrent arrhythmia. The overall annual rate of disease-related complications such as sudden death, end-stage heart failure and fatal stroke is approximately 1-2%, but risk in individual patients varies as a function of age, disease severity and the underlying cause of the hypertrophy. Genetic counselling and clinical risk stratification are relevant for all patients. Subsets of patients require septal alcohol ablation, septal myectomy and implantable cardioverter defibrillators.