Hypertrophic Cardiomyopathy (HCM) is a complex genetic myocardial disease characterized by unexplained left-ventricular hypertrophy, dynamic outflow obstruction, arrhythmias, and risk of sudden cardiac death. This session delivers a comprehensive, clinically grounded review of genetics, imaging, risk assessment, and therapy, similar in scope to a dedicated Hypertrophic Cardiomyopathy (HCM) track at a major cardiology conference, where experts share evolving evidence and advanced hypertrophic cardiomyopathy management strategies for diverse patient profiles.

The description begins with sarcomeric gene mutations, autosomal dominant inheritance, variable penetrance, and age-related expression of the HCM phenotype. Participants will explore how myocyte disarray, interstitial fibrosis, microvascular ischemia, and diastolic dysfunction contribute to symptoms such as dyspnea, chest pain, presyncope, and syncope. The session also explains how obstructive and non-obstructive forms present differently and how LVOT gradients, mitral systolic anterior motion, and papillary muscle anomalies shape clinical expression.

Diagnostic evaluation is covered in detail, including transthoracic echocardiography, stress echo, CMR with late gadolinium enhancement, cardiopulmonary exercise testing, ECG, ambulatory rhythm monitoring, and genetic testing. Attendees will learn to identify high-risk features such as extensive fibrosis, apical aneurysm, unexplained syncope, family history of sudden cardiac death, nonsustained VT, and marked wall thickness.

Therapeutic options are then reviewed step by step. The session discusses pharmacologic approaches with beta-blockers, non-dihydropyridine calcium-channel blockers, disopyramide, and myosin inhibitors, along with strategies for symptom control and exercise guidance. Participants will understand indications for septal reduction therapy—surgical myectomy or alcohol septal ablation—and how to select the right intervention based on anatomy, risk, and local expertise.

Risk stratification for ICD implantation is a major focus, integrating clinical, imaging, and rhythm-monitoring data. The session also addresses special populations including pediatric HCM, athletes, pregnant patients, and individuals with overlapping phenotypes that mimic HCM such as hypertensive heart disease, amyloidosis, Anderson–Fabry disease, and athlete’s heart.

Future directions include gene-silencing approaches, genome editing, disease-modifying therapies targeting fibrosis and energetics, and integration of AI-based risk prediction models into routine practice. The session also highlights the importance of family screening and cascade testing to identify at-risk relatives before symptoms develop. Algorithms for surveillance intervals, lifestyle advice, sports participation, and pregnancy planning are presented in practical, easy-to-adapt formats.

Real-life case discussions show how shared decision-making can balance symptom relief, sudden death prevention, and quality-of-life considerations, ensuring that treatment plans reflect both clinical science and individual patient goals. Attendees will receive structured checklists and sample clinic templates that can be used to standardize assessment across new and follow-up visits, promoting consistency among team members and across institutions and ensuring that no key risk factor is overlooked over time.