Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy

Published: December 2020
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  • Key Points
  • Shared Decision-Making
  • Multidisciplinary HCM Centers
  • Diagnosis Initial Evaluation and Follow-up
  • Echocardiography
  • CMR Imaging
  • Cardiac Computed Tomography
  • Heart Rhythm Assessment
  • Angiography and Invasive Hemodynamic Assessment
  • Exercise Stress Testing
  • Genetics and Family Screening
  • Individuals Who Are Genotype-Positive, Phenotype-Negative
  • SCD Risk Assessment
  • ICD Placement in High-risk Patients With HCM
  • Selection of ICD Device Type
  • Pharmacologic Management of Patients With Obstructive HCM
  • Invasive Treatment of Symptomatic Patients With Obstructive HCM
  • Management of Patients With Nonobstructive HCM With Preserved EF
  • Management of Patients With HCM and Atrial Fibrillation
  • Management of Patients With HCM and Ventricular Arrhythmias
  • Management of Patients With HCM and Advanced HF
  • Sports and Activity
  • Occupation in Patients With HCM
  • Pregnancy
  • Comorbidities
  • Tables
    • Suggested Competencies of Comprehensive and Primary HCM Centers
    • Example Targets for Invasive Septal Reduction Therapies Outcomes
    • Clinical Features in Patients with “HCM Phenocopies (Mimics)"
    • Screening With Electrocardiography and 2D Echocardiography in Asymptomatic Family Members
    • Established Clinical Risk Factors for HCM Sudden Death Risk Stratification
    • Antiarrhythmic Drug Therapy Options for Patients With HCM and AF
    • Lifestyle Considerations for Patients With HCM
  • Algorithms
    • Recommended Evaluation and Testing for HCM
    • Genetic Testing Process in HCM
    • ICD Patient Selection
    • Management of Symptoms in Patients With HCM
    • Heart Failure Algorithm
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The American College of Cardiology (ACC) continues to transform quality cardiovascular care and improve heart health after more than 60 years of existence through its mission, vision and values. The College is proud of its efforts to bring evidence-based clinical care into everyday practice.

Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. AHA's Professional Membership is a made up of a robust group of cardiovascular professionals who participate in discovery and dissemination of science.


This pocket guide attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. This pocket guide should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgment concerning the propriety of any course of conduct must be made by the clinician after consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool.


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