Echocardiography in the diagnosis and management of hypertrophic cardiomyopathy

Despite great advances in the molecular genetics of hypertrophic cardiomyopathy (HCM), echo-Doppler continues to remain the gold standard test in the diagnosis of the condition. There is no single cardiac disease In which echo-Doppler has proved so clinically valuable as in HCM. The review discusses the echocardiographic criteria for the diagnosis of HCM and the role of echo-Doppler in the determination of anatomical and functional abnormalities, assessment of changes which occur in the heart as the disease progresses and evaluation of medical and surgical therapies in the management of HCM. The major limitations of echo-Doppler in the diagnosis of HCM is that it fails to detect individuals who have inherited the disease but do not exhibit overt left ventricular hypertrophy and cannot always differentiate between physiological hypertrophy in highly trained elite athletes and pathological hypertrophy which has important implications because HCM is the commonest cause of death in athletes aged below 25 years. The main limitation of echocardiography in the management of patients with HCM is that it is of very limited use in determining the prognosis in a given individual with HCM.