Clinical presentations of hypertrophic cardiomyopathy and implications for therapy

[first paragraph of article] Hypertrophic cardiomyopathy (HCM) is diagnosed in the presence of left ventricular hypertrophy of  ≥ 15 mm in adult index cases, or  ≥ 13 mm in relatives of known affected patients, that is not solely explained by abnormal loading conditions . In children, the left ventricle (LV) wall thickness should be more than two standard deviations above the predicted population mean . The typical anatomo-pathological findings include myocyte hypertrophy, disarray, interstitial fibrosis and small-vessel disease . Although all the myocytes are supposed to be affected, pathological alterations are not uniformly distributed throughout the myocardium . Asymmetrical hypertrophy of the interventricular septum is the most commonly observed phenotype, but any pattern of hypertrophy is consistent with the diagnosis.