Comprehensive evaluation of hypertrophic cardiomyopathy: European Journal of Heart Failure expert consensus document

(i) Establish the correct diagnosis: differentiate sarcomeric hypertrophic cardiomyopathy (HCM) from phenocopies (amyloidosis, Fabry, mitochondrial disease) using multimodal imaging and genetic testing

(ii) Establish symptoms and LV outflow tract obstruction (left ventricular outflow tract obstruction (LVOTO)), with exercise echocardiography when required, to guide management incl. pharmacotherapy or septal reduction therapy

(iii) sudden cardiac death (SCD) risk stratification integrating risk scores with adjunctive imaging to support patient-centred ICD decisions

(iv) Genetic evaluation and family management: cascade testing, early detection, counselling

(v) Management of comorbidities (AF, hypertension, obesity, sleep-disordered breathing)

(vi) Education and lifestyle guidance: safe sport participation, avoidance of dehydration and vasodilators, reproductive counselling in a multidisciplinary setting