Protocol

Anatomy module (A) LV function module (B) LVOT cines (2 orthogonal views) Velocity encoding module (F), in and through LVOT planes LV tagging module (J), SA slices, 4CH - optional LGE module (E)

Report

Dimensions, mass (corrected for BSA) and function EDV, ESV , SV, EF and mass Thickening and function of myocardial segments Presence of LVOT obstruction at rest Presence of systolic anterior motion (SAM) Presence and extent of fibrosis

Key Points

Risk factors for sudden cardiac death in HCM: Positive family history Syncope Frequent repetitive NSVT Blood pressure drop during exercise Massive LV hypertrophy ≥30mm Presence and extent of LGE Consider possible obstruction under stress conditions

Tips and Tricks

LGE at the insertion points of the RV to the LV are non-specific and often seen even in normal subjects Suggestive for HCM: Localized hypertrophy Reduced contraction of hypertrophied segments Presence of LGE Tagging may help identify wall motion abnormalities Myocardial crypts may help to define HCM mutation carriers without LV hypertrophy

References

2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy. ESC Clinical Practice Guidelines 2014