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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.
