More than 60 years after the first description of “asymmetric septal hypertrophy of the heart,” hypertrophic cardiomyopathy (HCM) as a disease has continued to provide clinicians and researchers fertile grounds for debate and investigation. HCM, as a complex disease requiring a multidisciplinary approach, runs the gamut of all we learned in medical school and beyond–physiology, clinical medicine, genetics, imaging, diagnostics, pharmacotherapies, electrophysiology, interventional cardiology, and cardiothoracic surgical interventions. In this review, we discuss 30 contemporary controversies and considerations in HCM.Abbreviations: HCM: hypertrophic cardiomyopathy; LVH: left ventricular hypertrophy; nHCM: non-obstructive hypertrophic cardiomyopathy; oHCM: obstructive hypertrophic cardiomyopathy; LVOTO: left ventricular outflow tract obstruction; MVA: mitral valve apparatus; P: phenotype; G: genotype; MYH7: myosin heavy chain 7; MYPBC3: myosin binding protein C, cardiac type; ECG: electrocardiogram; SCD: sudden cardiac death; MR: mitral regurgitation; LA: left atrium; AF: atrial fibrillation; CMR: cardiac magnetic resonance imaging; LGE: late gadolinium enhancement; ICD: implantable cardioverter-defibrillator; ECV: extracellular volume; CPET: cardio-pulmonary exercise testing; SRT: septal reduction therapy; FDR: first-degree relative; NYHA: New York Heart Association; DOAC: direct oral anticoagulants; OAC: oral anticoagulants; AAD: anti-arrhythmic drugs; NSVT: non-sustained ventricular tachycardia; ACC: American College of Cardiology; AHA: American Heart Association; ESC: European Society of Cardiology; LVEF: left ventricular ejection fraction; S-ICD: subcutaneous implantable cardioverter-defibrillator; IAS: inappropriate shock; AVB: atrio-ventricular block; CHB: complete heart block; VT: ventricular tachycardia; ASA: alcohol septal ablation; ATP: anti-tachycardia pacing; TE: thromboembolism; SAM: systolic anterior motion; LBBB: left bundle branch block.
- Hypertrophic cardiomyopathy
- alcohol septal ablation
- sudden cardiac death
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine