Evidence for agressive therapy of obstruction in HOCM patients is still lacking. But obstruction with a high gradient lasting for years has to be harmful. Thus, clinicians have to consider safety of interventional/surgical therapy and natural prognosis of HOCM.
Thomas Bartel
I see a problem in asymptomatic patients as long as we have no data. However, exeptional and individual case assessment might be justified, e.g. in patients with very high gradient.
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Mohammed Akbar Bhat
We should not treat asymptomatic HOCM patients unless their the LVOT gradient is high. LV tolerates mild to moderate LVOT gradients very well. Objective Echocardiographic measurements at rest and after exercise help in taking decisions in selected cases.
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