Risk factors for sudden death in hypertrophic cardiomyopathy (HCM)

Hypetrophic Cardiomyopathy [Source]

Hypertrophic cardiomyopathy (HCM) is the commonest form of cardiomyopathy, with a prevalence 100 per 100,000.

Genetic
It is a genetic disorder with autosomal-dominant transmission, a high degree of penetrance and variable expression.

Clinical features
Symptoms and signs are similar to those of aortic stenosis, except that the character of the pulse is jerky in HCM.



Sudden death can be a presenting symptom. It typically occurs during or just after vigorous physical activity.

Risk factors for sudden death in HCM are:

• a history of previous cardiac arrest or sustained ventricular tachycardia
• recurrent syncope
• an adverse genotype and/or family history
• exercise-induced hypotension
• multiple episodes of non-sustained ventricular tachycardia on ambulatory ECG
• a marked increase in the thickness of the left ventricular wall