Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of non-obstructive hypertrophic cardiomyopathy (HCM). Reports [stable/worsening] exertional dyspnea, [presence/absence] of atypical chest pain, and [presence/absence] of palpitations or presyncope. No evidence of syncope or paroxysmal nocturnal dyspnea. Current functional status is NYHA Class [I/II/III/IV]. Adherence to current pharmacotherapy is [good/poor].
Clinical Examination Findings
Cardiovascular exam: Regular rate and rhythm, S1 and S2 heart sounds normal. No audible systolic murmur at the left sternal border. No evidence of dynamic outflow tract obstruction (no change in murmur intensity with Valsalva). Carotid upstroke is normal. Peripheral pulses are symmetric, no peripheral edema. Lungs are clear to auscultation bilaterally.
Treatment Protocol
Continue current regimen of [Beta-blocker/Calcium channel blocker] for symptom management and heart rate control. Maintain strict hydration and avoid volume depletion. Avoid high-intensity competitive sports. Schedule annual transthoracic echocardiogram (TTE) and Holter monitoring for arrhythmia surveillance. Discussed importance of family screening and genetic counseling.