5th July 2026

Complications

Arrhythmias and SCD
- HCM is associated with an increased risk of ventricular arrhythmias, which can lead to syncope, cardiac arrest, or sudden cardiac death, particularly in young individuals, athletes, or those with a family history of SCD.
- Following septal myectomy, likely due to atrial remodelling and changes in haemodynamics following the reduction of LVOT obstruction, atrial fibrillation can be a common complication.
Heart Failure
- Severe left ventricular hypertrophy, diastolic dysfunction, and outflow tract obstruction can lead to heart failure symptoms.
Mitral Valve Abnormalities
- Mitral valve abnormalities, including mitral regurgitation and systolic anterior motion of the mitral valve, can contribute to heart failure symptoms and increase the risk of arrhythmias.
Endocarditis
- HCM is associated with structural abnormalities such as hypertrophied myocardium and altered blood flow dynamics, particularly in the left ventricular outflow tract. These structural changes create areas of turbulence and endothelial injury, which can facilitate bacterial colonisation and increase the risk of endocarditis.
- Endocarditis in HCM can lead to severe complications such as worsening heart failure, arrhythmias, systemic embolisation (e.g., stroke), and even death.

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