cardiovascular disorders
Hypertrophic Cardiomyopathy Arrhythmias
Diagnosis of Hypertrophic Cardiomyopathy Arrhythmias
ECG, echocardiography, and often cardiac MRI Often ambulatory cardiac monitoring Rarely, genetic testing Screening of first-degree family members The diagnosis of hypertrophic cardiomyopathy is suggested by an ECG showing left ventricular hypertrophy and by characteristic clinical findings on physical examination. Diagnosis is confirmed by cardiac imaging, usually transthoracic echocardiography, showing left ventricular hypertrophy, particularly asymmetrical left ventricular hypertrophy. A cardiac magnetic resonance examination using gadolinium is then done to quantify left ventricular scarring, which helps assess risk of sudden cardiac death. Arrhythmia evaluation usually includes ambulatory cardiac rhythm monitoring and exercise testing. Patients also should have regular (eg, annual) clinical follow-ups, including ECG, echocardiography, ambulatory cardiac rhythm monitoring, and exercise testing. Because of its low sensitivity, genetic testing is not recommended for patients but may be used to screen family members if a specific mutation in the family is known or for patients with genetic links to a geographic region where a local mutation is known to be present. Family members also should have clinical evaluation (ie, to detect symptoms suggestive of arrhythmia and/or heart failure), ECG, and echocardiography. 