Hypertrophic obstructive cardiomyopathy: Alternative therapeutic options

Hypertrophic obstructive cardiomyopathy (HOCM) is now recognized to be a relatively uncommon form of heart disease, but one that is frequently responsible for progressive symptoms of heart failure, angina, and sudden cardiac death. Symptoms are usually caused by obstruction to the left ventricular outflow tract, and relief of this obstruction is usually followed by clinical and hemodynamic improvement. Choice of treatment for HOCM is confounded by the variable and unpredictable natural history the disease. The annual mortality rate is approximately 3 to 4% per year. Most of these deaths occur suddenly, especially in patients with a family history of HOCM, a history of syncope, and a diagnosis in childhood. Alternative therapeutic options are discussed.