Assessing Risk in Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy has fascinated clinicians and clinical investigators since its initial description almost 50 years ago because of the unique physical findings, often bizarre electrocardiographic aspects, unusual shape of the left ventricle on contrast ventriculography, typically asymmetric distribution of hypertrophy on echocardiography, and abnormal filling of the left ventricle in diastole. Some aspects of the disease have generated considerable controversy, such as the mechanism (and even the existence) of dynamic intraventricular pressure gradients in some patients.No less contentious is the debate about how clinicians might predict the most feared complication of this disease: sudden death. Although clinical predictors of . . .