The medical management of the patient with hypertrophic cardiomyopathy involves minimizing diastolic dysfunction, reducing left ventricular outflow tract obstruction, optimizing heart failure management, maintaining normal sinus rhythm, rate control and anticoagulation in the presence of atrial fibrillation, and implantation of an automatic implantable cardiac defibrillator in those patients who survive sudden cardiac death.
One of the fundamental goals of treatment is to relieve disabling dyspnea and improve exercise tolerance.  It should be noted that the majority of patients do not have outflow tract obstruction, and therefore would not benefit from surgery. Medical therapy is, therefore, a mainstay of treatment.  Given the limited number of patients with the condition, there are few randomized trials comparing strategies/agents in the management of HCM.
In all patients with hypertrophic cardiomyopathy risk stratification is essential to attempt to ascertain which patients are at risk for sudden cardiac death. In those patients deemed to be at high risk the benefits and infrequent complications of defibrillator therapy are discussed; devices have been implanted in as many as 15% of patients at HOCM centers. Treatment symptoms of obstructive HOCM is directed towards decreasing the left ventricular outflow tract gradient and symptoms of dyspnea, chest pain and syncope.
Women with hypertrophic cardiomyopathy should be managed by a skilled cardiovascular specialist and a high-risk obstetrician during pregnancy. Any activity, drug or circumstance that increases left ventricular outflow obstruction, reduced left ventricular filling, or increases left ventricular afterload should be avoided.
Hypertrophic cardiomyopathy medical therapy
Hypertrophic cardiomyopathy medical treatment
Stress cardiomyopathy medical therapy
Noncompaction cardiomyopathy medical therapy
Dilated cardiomyopathy medical therapy
Aortic stenosis medical therapy
Hypertrophic cardiomyopathy interventions
Chronic mitral regurgitation treatment