Treatment of Hypertrophic Cardiomyopathy with Angina-Like Chest Pain on Exertion and No Left Ventricular Outflow Tract Obstruction

In some patients with hypertrophic cardiomyopathy, angina-like chest pain occurs on exertion despite the absence of left ventricular outflow tract obstruction or obstructive coronary artery disease. This distinct clinical scenario calls for a targeted pharmacological approach aimed at symptom relief.

Clinical Scenario

Angina-like chest pain on exertion; no left ventricular outflow tract obstruction.

Treatment Approach

Specific cardiac medications — drawn from established drug classes used in heart rate and symptom management — are recommended as the primary step. The complete selection and sequencing are detailed in the full protocol.

Clinical Goal

Improvement of symptoms.

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References

Beta-blockers and calcium antagonists (verapamil or diltiazem) should be considered to improve symptoms in patients with angina-like chest pain even in the absence of LVOTO or obstructive CAD.

DOI: 10.1093/eurheartj/ehad194

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