[Diagnostic awareness and red flags in hypertrophic cardiomyopathy in daily clinical practice].

Hypertrophic cardiomyopathy is the most common structural myocardial disease. Based on the literature, its estimated prevalence in the adult population is 1 : 500. It is distinguished by an exceptionally heterogeneous clinical presentation and a broad spectrum of disease trajectories. The disorder is recognised in only about 10% of the patients. In 90% of cases, patients remain undiagnosed, often due to the absence of symptoms. Hypertrophic cardiomyopathy is frequently the underlying cause of sudden cardiac death. In recent years, mortality of hypertrophic cardiomyopathy has declined due to improved device and pharmacotherapies. We aim to present the epidemiological significance of the disease in line with recent international guidelines, emphasizing the importance of diagnostic awareness and multiparametric evaluation. By promoting a cardiomyopathy mindset, we aim to raise awareness of clinical red flags. Early identification of patients with suspected hypertrophic cardiomyopathy in primary and cardiology outpatient care can facilitate prompt diagnosis and timely initiation of appropriate therapy. The review provides an overview of the diagnostic pathway recommended by the 2023 European Society of Cardiology Guidelines for the management of cardiomyopathies, describes the key components of the multiparametric, multimodal evaluation and presents clinical red flags. A significant proportion of the clinical red flags emphasized in the 2023 European Society of Cardiology Guidelines for the management of cardiomyopathies can be identified at lower levels of care and in primary care settings, thereby accelerating the diagnostic process and shortening the time to treatment. The diagnostic algorithm includes performing an ECG, assessing specific laboratory parameters, searching for extracardiac symptoms and conducting a comprehensive pedigree analysis focused on age-related phenotypic features. When clinical suspicion is high, advanced multimodal imaging should be included in addition to conventional imaging modalities. Orv Hetil. 2026; 167(38): 1495-1506.