HOCM: Prognostic Factors

Key points

• HOCM: autosomal dominant; defects in genes encoding contractile proteins (beta-myosin, alpha-tropomyosin, troponin T); septal hypertrophy → LV outflow obstruction.
• Important cause of sudden death in apparently healthy individuals.
• Poor prognostic factors: syncope · family history of sudden death · young age at presentation · non-sustained VT on 24/48-h Holter · abnormal BP response to exercise.
• Increased septal wall thickness also confers poor prognosis.

Decision points in this pathway

• High-risk features present?

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