Is Hypertrophic Cardiomyopathy (HCM) the same as Hypertrophic Obstructive Cardiomyopathy (HOCM)?

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From the Guidelines

HCM and HOCM are not exactly the same, though they are related conditions, with HCM being the broader term that refers to a genetic heart condition characterized by abnormal thickening of the heart muscle, and HOCM being a specific subtype of HCM where the thickened heart muscle causes an obstruction to blood flow from the left ventricle to the aorta.

Key Differences

  • HCM is a genetic heart condition characterized by abnormal thickening of the heart muscle, particularly the left ventricle [ 1 ].
  • HOCM is a specific subtype of HCM where the thickened heart muscle causes an obstruction to blood flow from the left ventricle to the aorta [ 1 ].

Clinical Implications

  • The distinction between HCM and HOCM is important for treatment approaches, as HOCM may require specific interventions to address the obstruction, such as beta-blockers, calcium channel blockers, disopyramide, septal myectomy surgery, or alcohol septal ablation [ 1 ].
  • Non-obstructive HCM may be managed differently, focusing on symptom control and prevention of complications like arrhythmias [ 1 ].

Diagnosis and Management

  • The diagnosis of HCM and HOCM requires careful evaluation, including clinical markers and testing strategies to distinguish them from other cardiac conditions with left ventricular hypertrophy [ 1 ].
  • Both conditions share the same genetic basis and carry risks of heart failure, arrhythmias, and sudden cardiac death, requiring careful monitoring and management [ 1 ].

From the Research

Definition and Classification

  • Hypertrophic cardiomyopathy (HCM) is a primary disorder of the heart muscle characterized by muscular hypertrophy without a recognized cause, which encroaches on the ventricular chamber, reducing chamber area and volume 2.
  • HCM can be classified into two types: obstructive (HOCM) and non-obstructive (HNCM), depending on the presence of left ventricular outflow tract (LVOT) obstruction at rest or during provocation 3, 4.

HCM and HOCM

  • HOCM is a subtype of HCM, characterized by the presence of a LVOT gradient at rest or during provocation, such as with Valsalva maneuver or exercise 3.
  • Not all patients with HCM have HOCM, as some may have non-obstructive HCM (HNCM) 4.
  • The symptoms and treatment of HCM and HOCM may differ, with HOCM requiring specific therapies to reduce dynamic obstruction 3, 4, 5.

Key Differences

  • The main difference between HCM and HOCM is the presence of LVOT obstruction, which is a key feature of HOCM 3, 4.
  • HOCM is characterized by a higher risk of sudden cardiac death and requires specific therapies to reduce dynamic obstruction 3, 4, 5.
  • The treatment of HCM and HOCM may involve different approaches, including pharmacologic therapy, septal reduction therapy, and surgical interventions 3, 4, 6, 5, 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Medical, surgical and interventional management of hypertrophic cardiomyopathy with obstruction.

Current treatment options in cardiovascular medicine, 2012

Research

The diagnosis and treatment of hypertrophic cardiomyopathy.

Deutsches Arzteblatt international, 2011

Research

Hypertrophic Cardiomyopathy: Clinical Update.

JACC. Heart failure, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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