Published online Aug 26, 2014. doi: 10.4330/wjc.v6.i8.764
Revised: April 29, 2014
Accepted: May 28, 2014
Published online: August 26, 2014
Processing time: 217 Days and 1.3 Hours
Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death (SCD) in the young, particularly among athletes. Identifying high risk individuals is very important for SCD prevention. The purpose of this review is to stress that noninvasive diagnostic testing is important for risk assessment. Extreme left ventricular hypertrophy and documented ventricular tachycardia and fibrillation increase the risk of SCD. Fragmented QRS and T wave inversion in multiple leads are more common in high risk patients. Cardiac magnetic resonance imaging provides complete visualization of the left ventricular chamber, allowing precise localization of the distribution of hypertrophy and measurement of wall thickness and cardiac mass. Moreover, with late gadolinium enhancement, patchy myocardial fibrosis within the area of hypertrophy can be detected, which is also helpful in risk stratification. Genetic testing is encouraged in all cases, especially in those with a family history of HCM and SCD.
Core tip: Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death (SCD) in the young, particularly among athletes. Noninvasive diagnostic testing is important for risk assessment. Extreme left ventricular hypertrophy, documented ventricular tachycardia and fibrillation increase the risk of SCD. Fragmented QRS complex and T wave inversion in multiple leads are more common in high risk patients. Cardiac magnetic resonance imaging with late gadolinium enhancement, patchy myocardial fibrosis within the area of hypertrophy can be detected, which is also helpful in risk stratification. Genetic testing is encouraged in all cases, especially in those with family history of HCM and SCD.