Diagnosis of ischemia in hypertrophic cardiomyopathy

摘要: Purpose of review Chest pain and myocardial ischemia are common features in patients with hypertrophic cardiomyopathy (HCM). This addresses diagnostic roles computed tomography nuclear stress testing (NST) HCM. Recent findings Current evidence showed the limitation NST diagnosis epicardial coronary artery stenosis due to prevalent microvascular dysfunction. In this context, excellent negative predictive value angiography (CCTA) makes it very attractive serve as a gatekeeper invasive low-risk symptomatic patients, either first noninvasive imaging test choice or after presence perfusion defect seen NST. Furthermore, identification atherosclerosis process absence obstructive lesion could have impacts on management risk factors for disease. We also propose an algorithm evaluation HCM based recent evidence. Summary low-intermediate-risk HCM, both CCTA acceptable tools ischemia. defect, can be used rule out significant stenosis. Presence major high-risk considered angiography.