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Europace Advance Access originally published online on May 23, 2007
Europace 2007 9(9):817-822; doi:10.1093/europace/eum093
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

SYNCOPE

Syncope in hypertrophic cardiomyopathy: mechanisms and consequences for treatment

Lynne Williams* and Michael Frenneaux

1 Department of Cardiovascular Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, West Midlands, UK

Hypertrophic cardiomyopathy (HCM) is an inherited disease with marked phenotypic variability that includes the extent of hypertrophy, the presence and severity of symptoms, and the natural history of the disease. Symptoms of impaired consciousness (syncope and pre-syncope) occur in approximately 15–25% of patients with hypertrophic cardiomyopathy (HCM). In young patients a history of recurrent syncope is associated with an increased risk of sudden death. Detailed investigations identify a probable mechanism in a minority of these, usually paroxysmal atrial fibrillation or ventricular tachycardia. In the majority, however, no likely mechanism is found despite extensive investigation. Although this may be the case, it is still of vital importance to exclude potentially treatable causes of syncope.

Key Words: Hypertrophic cardiomyopathy, Syncope, Sudden death, Arrhythmias, Abnormal vascular control

* Corresponding author. Tel: +44 121 415 8825; fax: +44 121 414 3713. E-mail address: l.k.williams{at}bham.ac.uk

Manuscript submitted 28 February 2007. Accepted after revision 7 April 2007.


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