Highlighting the hidden risks and diagnostic challenges of hypertrophic cardiomyopathy (HCM)
HCM is a chronic, progressive cardiovascular disease that can leave patients with debilitating symptoms and potentially life-threatening complications1
It is estimated that HCM affects up to
1:200 to
1:500
people—yet ~85% of patients remain undiagnosed in the US*†
within the general population3
Diagnosing HCM
Recognizing HCM early can be challenging—but it makes all the difference
*Based on 2013 ICD-9 claims data analysis (N=169,089,614): An estimated 700,000 overall US prevalence of HCM (1. ~100,000 patients with diagnosed HCM [based on 2013 US Census population], 2. ~600,000 patients with undiagnosed HCM [based on analysis’ assumption that 1 in 500 prevalence represents clinically unrecognized cases]).
†Estimated undiagnosed range calculated using prevalence of 1:500, estimated US population (332,330,571 in May 2021), and estimated diagnosed population (~100,000).
Could It Be HCM? Reveal the Masquerader?
Suspect HCM when your patient presents with4:
Nonspecific, limiting cardiac symptoms
Previous cardiac event
Family history of HCM
Heart murmur/ECG abnormalities
Confirm HCM through cardiac imaging1,5,6:
Utilize echocardiogram as primary imaging modality to reveal structural and functional abnormalities
Utilize provocative maneuvers as appropriate to identify existing LVOT peak gradients that may be minimal or absent at rest
Consider CMR when echo findings are inconclusive
Combat the complexities of HCM5,7:
Engage in shared decision-making with your patient and evaluate their goals for treatment
Explore and discuss current treatment options with your patient
CMR, cardiac magnetic resonance; ECG, electrocardiogram; echo, echocardiogram; LVOT, left ventricular outflow tract.
REFERENCES:
- Naidu SS, ed. Hypertrophic Cardiomyopathy. London, Eng: Springer-Verlag; 2015.
- Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2015;65(12):1249-1254.
- Maron BJ, Gardin JM, Flack JM, Gidding SS, Kurosaki TT, Bild DE. Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA study. Coronary artery risk development in (young) adults. Circulation. 1995;92(4):785-789.
- Mitchell CC, Frye C, Jankowski M, et al. A practical approach to echocardiographic imaging in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2023;36(9):913-932.
- Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the management of hypertrophic cardiomyopathy: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(23):e1239-e1311.
- Nagueh SF, Phelan D, Abraham T, et al. Recommendations for multimodality cardiovascular imaging of patients with hypertrophic cardiomyopathy: an update from the American Society of Echocardiography, in collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2022;35(6):533-569.
- Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. N Engl J Med. 2018;379(7):655-668.