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08-11-2011 | Cardiology | Article

AHA/ACC release first science-based guidelines on hypertrophic cardiomyopathy


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MedWire News: The American Heart Association (AHA) and American College of Cardiology (ACC) have released their first science-based guideline on hypertrophic cardiomyopathy (HCM).

The new guidelines for the diagnosis and treatment of HCM, which occurs in one of every 500 people, are published in the journal Circulation and the Journal of the American College of Cardiology.

Co-chairman of the writing committee Bernard Gersh (Mayo Clinic, Rochester, Minnesota, USA) and team recommend drugs such as the calcium channel blocker verapamil or the sodium channel blocking antiarrhythmic disopyramide, to control symptoms of HCM, including shortness of breath.

The most appropriate treatment for advanced heart failure due to obstruction in patients who do not respond to medication, remains transaortic surgical septal myectomy, they emphasize.

However, for patients who are not candidates for surgery, catheter-based septal ablation, which introduces alcohol in the heart to induce myocardial infarction, and reduce the muscle mass of the septum, is the alternative option.

The guidelines stress that all patients who are diagnosed with HCM should undergo a comprehensive evaluation of their risk for sudden cardiac arrest, including a personal and family history, and a noninvasive assessment using an echocardiogram.

HCM patients should also be offered genetic counseling and genetic testing if appropriate, according to the new guidelines.

Regardless of whether they have an obstruction or not, HCM patients should not participate in high-intensity competition sports, including basketball, tennis, and soccer. Low-intensity competitive sports including golf, bowling, and snorkeling are permitted.

Sudden death in HCM can be prevented using the implantable defibrillator in selected patients who are deemed to be at high risk, based on risk markers including fainting, or a history of a family member with sudden death, the writing committee says.

"HCM is widely misperceived as a fatal condition, but a diagnosis of HCM is not a diagnosis of sudden cardiac death," said Gersh in a press statement.

"Although it remains the most common cause of sudden death in the young and competitive athlete, effective treatments now exist to help most patients manage their condition."

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By Piriya Mahendra

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