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Hypertrophic Cardiomyopathy 2024

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Issue link: https://eguideline.guidelinecentral.com/i/1521559

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Page 1 of 43

2 Key Points Top 10 Take-Home Messages 1. Shared decision-making is essential to provide the best clinical care. This involves thoughtful dialogue among patients, families, and their care team in which health care professionals present all available testing and treatment options; discuss the risks, benefits, and applicability of those options to the individual patient; and ensure the patient expresses their personal preferences and goals to develop their treatment plan. 2. Although the primary cardiology team can initiate evaluation, treatment, and longitudinal care, referral to multidisciplinary hypertrophic cardiomyopathy (HCM) centers with appropriate expertise can be important to optimizing care for patients with HCM. Challenging treatment decisions—where reasonable alternatives exist, where the strength of recommendation is weak (eg, any decision relying on a Class of Recommendation 2b) or is particularly nuanced (eg, interpretation of genetic testing; primary prevention implantable cardioverter-defibrillator decision-making), and for HCM-specific invasive procedures—may critically benefit from involving specialized HCM centers. 3. Careful ascertainment of family history, counseling patients with HCM about the potential for genetic transmission of HCM, and options for genetic testing are cornerstones of care. Screening first- degree family members of patients with HCM, using either genetic testing, serial imaging, or electrocardiographic surveillance as appropriate, can begin at any age and can be influenced by specifics of the patient and family history and family preference. Because screening recommendations for family members hinge on the pathogenicity of any detected variants, the reported pathogenicity should be reconfirmed every 2 to 3 years, and input from specialized HCM centers with genetics expertise may be valuable.

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