Fast Five Quiz: Hypertrophic Cardiomyopathy Workup

Jamshid Shirani, MD


April 13, 2022

A nondilated left ventricle with a maximum wall thickness of at least 15 mm is the defining feature of HCM. However, wall thickness of 13-14 mm in patients with a family history of HCM or positive genotype may be diagnostic particularly in the presence of distinctive features such as asymmetrical septal hypertrophy and dynamic LVOT obstruction owing to contact between the septum and mitral valve during systole.

Physiological cardiac hypertrophy with a left ventricular wall thickness between 13 and 18 mm is often seen in individuals who participate in competitive sports. The left ventricular cavity, which is enlarged in physiological hypertrophy and not enlarged in HCM, is an important distinguishing feature.

Although mitral regurgitation is a common finding in HCM, isolated mitral regurgitation is not consistent with HCM. However, when present, mitral regurgitation is one of the factors contributing to development of symptomatic heart failure and atrial fibrillation.

Learn more about hypertrophic cardiomyopathy.


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