Hypertrophic cardiomyopathy (HCM, obstructive)
- Treat symptoms + LV outflow obstruction
- Beta blocker is common first drug
- Verapamil/diltiazem if beta blocker unsuitable
- Persistent symptoms → cardiac myosin inhibitor
- mavacamten or aficamten
- Severe refractory obstruction → septal reduction
- Avoid excessive preload/afterload reduction
Use at a glance
- Treat symptoms + LV outflow obstruction
Treatment options
- Beta blocker is common first drug
- Persistent symptoms → cardiac myosin inhibitor
- mavacamten or aficamten
Escalation / refractory disease
- Verapamil/diltiazem if beta blocker unsuitable
- Severe refractory obstruction → septal reduction
Safety / pitfalls
- Avoid excessive preload/afterload reduction
Self-check
- What is a common first drug for obstructive HCM?
A beta blocker. - What hemodynamic changes should be avoided in obstructive HCM?
Excessive preload/afterload reduction.
Drugs used for this (2)
All clinical uses · Open Hypertrophic cardiomyopathy (HCM, obstructive) in the interactive console ↗