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9.3. Pregnancy in Patients With HCM
COR LOE
Recommendations
2a C-LD
8. In pregnant women with HCM, general or epidural
anesthesia is reasonable, with precautions to avoid
hypotension.
2a C-EO
9. In pregnant women with HCM, it is reasonable to perform
serial echocardiography, particularly during the second or
third trimester when hemodynamic load is highest, or if
clinical symptoms develop.
2b C-EO
10. In pregnant women with HCM, fetal echocardiography may
be considered for diagnosis of fetal HCM in the context of
prenatal counseling.
3: Harm C-EO
11. In pregnant women, use of mavacamten is contraindicated
due to potential teratogenic effects.
9.4. Patients With Comorbidities
COR LOE
Recommendations
1 C-EO
1. In patients with HCM, adherence to the ACC/AHA
primary prevention guideline is recommended to reduce risk
of cardiovascular events.
1 B-NR
2. In patients with HCM who are overweight or obese,
counseling and comprehensive lifestyle interventions are
recommended for achieving and maintaining weight loss and
possibly lowering the risk of developing LVOTO, HF, and
AF.
1 C-LD
3. In patients with HCM and hypertension, lifestyle
modifications and medical therapy for hypertension are
recommended, with preference for beta blockers and
nondihydropyridine calcium channel blockers in patients
with obstructive HCM.
1 C-LD
4. In patients with HCM, assessment for symptoms of sleep-
disordered breathing is recommended and, if present, referral
to a sleep medicine specialist for evaluation and treatment is
recommended.
(cont'd)
