Key Patient Messages: Hypertrophic Cardiomyopathy 2024 Clinical Practice Guideline
Published: May 08, 2024
- Shared Decision-Making (SDM) leads to better health outcomes in patients with heart health conditions including HCM. With this approach the patient shares their goals and preferences for treatment and the clinician shares the best treatment options. This helps patients understand how recommended treatments and lifestyle changes may affect their health, and clinicians can guide patients towards treatment options that best meet their needs and preferences.
- Patients with HCM should be encouraged to seek care at a multidisciplinary center, particularly for HCM specific procedures and complex treatment and lifestyle decisions. Multidisciplinary centers offer diagnostic testing, advanced treatments, procedures, and a nuanced understanding of lifestyle and treatment decisions specific to patients with HCM. Generally, patients see the best results when treated at specialty centers.
- Exercise is beneficial for most patients with HCM. Previously, patients with HCM were discouraged from exercise, particularly vigorous exercise because of the fear of sudden cardiac death. New research shows exercise can be safe and beneficial for both adolescents and adults, but consultation with a clinician is critical before embarking on an exercise program. It’s important to know that exercise can improve the overall heart health of patients with HCM, just like patients without HCM. Participation in competitive sports or high intensity physical activity may be possible for some patients with HCM but needs to be discussed with a clinician with specific expertise in HCM in athletes.
- In the last few years, a new class of drugs called cardiac myosin inhibitors, has been specifically developed to treat patients with obstructive HCM. Specifically, the drug Mavacamten has been FDA approved. For some patients, this new type of drug can be an alternative to other medications and/or invasive procedures. This drug works by reducing heart muscle contractions that lead to obstruction in the heart. However, patients that take this medication require careful monitoring. For eligible patients considering this treatment option, engaging in shared decision-making is very important to ensure patients understand their options, how this treatment will affect their health, and fit with their treatment goals and preferences.
- Understanding the risk for Atrial Fibrillation (AFib) and stroke is important for patients with HCM. Patients with HCM are at increased risk of experiencing a type of irregular heartbeat called Atrial Fibrillation (AFib). During AFib the heart pumps blood abnormally. Because the blood isn’t circulating properly, this may cause blood to pool in the heart and form blood clots. These clots can travel through blood vessels to the brain, causing a blockage leading to stroke. Therefore, any episode of atrial fibrillation should be followed by a shared decision-making conversation about treatment options with your medical professional.
Citation
Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps-Anderson KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophiccardiomyopathy: a report of the American Heart Association/American College of Cardiology Joint Committee onClinical Practice Guidelines. Circulation. Published online May 8, 2024. doi: 10.1161/CIR.0000000000001250
