Hypertrophic cardiomyopathy evolving management: American Heart Association/American College of Cardiology vs. European Society of Cardiology guidelines

The availability of cardiac myosin inhibitors (CMI) to treat symptomatic left ventricular outflow tract obstruction (LVOTO) and the evolving recommendations on exercise in patients with hypertrophic cardiomyopathy (HCM) have prompted the need for updated guidelines. The European Society of Cardiology (ESC) guidelines for the management of cardiomyopathies, which provide a focused updated of the 2014 HCM guidelines,1 and the American Heart Association/American College of Cardiology/Multisociety (AHA/ACC) guideline on the management of HCM2 offer revised recommendations that largely agree on core principles, but also present some differences worth revisiting. In this viewpoint, we explore some of the novelties and the main points of divergence between European and American recommendations on key areas of HCM diagnosis, evaluation, and management