From European Society of Cardiology:

Rome, Italy – 28 Aug 2016: Sudden death in patients with hypertrophic cardiomyopathy (HCM) is rarely associated with exercise, according to research presented at ESC Congress 2016 today by Dr Gherardo Finocchiaro, a cardiologist at St George’s University of London, UK.1 Nearly 80% of patients in the study had no symptoms and only one in five had been diagnosed with HCM before their death.

Dr Finocchiaro said: “HCM is an inherited heart muscle disease with variable clinical expression and natural history. It is characterised by hypertrophy of the left ventricular walls (‘thick heart muscle’). Sudden cardiac death (SCD) is a relatively common cause of mortality in patients with HCM. It is caused by fatal arrhythmias which can be effectively treated with implantable cardioverter defibrillators (ICDs).”

“Exercise is considered a trigger of fatal arrhythmias and international recommendations advise patients with a clear phenotypic expression of HCM to avoid competitive sports,” continued Dr Finocchiaro. “It is unclear however if SCD occurs more frequently at rest or during exercise in these patients.”

The current study investigated the circumstances and demographics of SCD in 184 HCM patients enrolled from 1994 to 2014 at St George’s Hospital Cardiac Pathology centre. All patients underwent a detailed post-mortem examination by an expert cardiac pathologist to confirm the diagnosis of HCM. Clinical information was obtained from referring coroners. Patients were 39 years of age on average and 70% were men.

Only 20% of patients had an ante-mortem diagnosis of HCM. Just 22% of patients had exhibited cardiac symptoms such as palpitations, dyspnoea, syncope and chest pain.

Dr Finocchiaro said: “Diagnosis is often missed during life and HCM may be a ‘silent killer’ where the first manifestation of the disease is commonly SCD. In fact patients are often asymptomatic (78% in our study) and the diagnosis may be triggered by an abnormal …

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